PTO 114 | Managing Multiple Clinics


Steve Anderson, PT has owned clinics and managed a large PT organization in his past. Thus, he's primed to expound on the challenges that owners face when they own and manage multiple clinics. Although the thought of expansion is exciting, it takes a different level of leadership and management from the owner(s). In this episode, Steve joins Nathan Shields as they cover some of the key aspects to consider if you're running multiple clinics or looking to do so in your future.


Listen to the podcast here:

Keys To Managing Multiple Clinics With Steve Anderson, PT

I've got a returning guest, Steve Anderson. He was with me as we talked about PPS and the Peer2Peer network. Thanks for coming on. I appreciate it.

You're welcome. I’m glad to be here.

If you want to hear about his story, you can go back and read that prior episode. In a nutshell, Steve is the ex-CEO of Therapeutic Associates, which has almost 100 clinics in the Pacific Northwest. Now, he is working as an executive coach under Orange Dot Coaching and also the host of his own podcast, Profiles in Leadership. I'm excited to bring him back on. Based on his experience, he was the CEO of an almost 100-clinic company in the Pacific Northwest. I figured it was important to bring him on because I wanted to talk with Steve about the differences between what it takes in leadership to own multiple clinics versus a single clinic.

Some of you might be in that stage where you're thinking about expanding, or maybe you have two clinics. It's wearing your thin or pulling you at both ends and burning the midnight oil. I've been there before. I thought I'd talk about some of the things that we can do to improve our leadership capabilities when it comes to owning more than one physical location. Steve, what’s the big difference between someone who owns a single location and someone who has multiple locations? How do they manage their time better? How do they do better as a leader? What do they need to be aware of in order to make that transition?

The first thing you have to say is that you can't do it all. You think, “We have one location now. I'm doing great. I'm going to do the exact same thing in the other location.” You probably don't have double the time to do that. I'm very big on identifying what is your intent to open another clinic or a number of clinics. Do you want to do that as a business strategy so that then you're going to have multiple clinics and then sell it to somebody else as a business strategy? Do you want those new clinics to be part of your organization, grow but keep it within your ownership style? Understanding what your intent is important because you could approach it in two different ways.

If you want physical sites down that do pretty well, and then you're going to sell that down the road, you'd probably want to keep the ownership piece of it tight because you'd want to benefit from that leveraging and selling. If you want to build more of what I would call maybe a legacy company or a company for your career, you'd want to make sure that people that you put as directors in those clinics have the skill and the ability to learn and grow. They can be successful as you are in the practice that you're in so that you can grow that way. I think being intentional about what you're trying to do is the first step.

It sounds like it goes back to what your purpose is, what makes you want to do this in the first place? Going back to what's your personal purpose and make sure your business is in alignment with that, and then taking the next step to make sure that you are putting yourself in a position or a role that aligns with that purpose. We often see people who find some success in a single clinic and see an opportunity in another community and want to open up another clinic without thinking ahead too much about, “I can't do it all.” You’ve got to figure out, “I can't treat full-time and manage two clinics. That's going to spread me too thin.” For some reason, we might even be a little bit naïve to think that, “If I hire the right PT, they can run it. I'll collect the cash and make sure everything runs as I do here.” That's not the way to go.

No, it's not. The strategy that makes the most sense to identify a good director for this new clinic or more clinics than your own. You have to invest time and energy into mentoring them and helping them learn and grow in that position. You can't assume that because they're a good PT that they know how to run a clinic or they know how to manage people as it grows. That's where you come in as a mentor-coach type of relationship with those people. It takes time again away from your practice to do this. You have to create opportunities for you to help them learn and grow. People make the mistake, “I'll put this person over here in this clinic and I'll keep doing what I'm doing and they're going to do great.” They may or they may not, but I guarantee you they'll do better if you take the time to mentor them and help them learn and grow.

Managing multiple clinics requires a committed purpose, solid policy and procedure, and a dependence on objective reports coming from a leadership team. Click To Tweet

You brought this up in our mastermind meeting. It was valuable and it made me recall some of the more successful PT owners that I know and that I've interviewed. Their system is such that they have a seating system. They have a leadership development program. I know that's how you developed it within Therapeutic Associates as well. They have the same thing there and that is they open up clinics, would you say after they've established the right person? They find the right person first and develop them and then move them onto that opportunity instead of finding the location first and then hoping to build someone into that?

That's the best way to do it. It's all about the person. One of the executives in TA always used the horse, the track and the jockey and what's the most important. The jockey is the most important thing. You need to make sure that you have somebody for that position. A lot of people used to ask us at Therapeutic Associates like, “Why do you guys keep expanding? Are you trying to take over the world or what's going on?” The easy answer is that we have some great people in that organization. We want them to have the same opportunity that I had when I came through, which is a chance to have your own clinic, be the leader of it, build it up, and be successful.

If you don't have opportunities for people like me and others that were seeking that out, we're probably going to leave and do it ourselves or go with somebody else who gives us that opportunity. Getting back to your question, the best directors are the ones that you know, that have worked with you, that understands your culture, that understand what you're trying to do. You provide them with a growing opportunity by putting them in a different clinic so that they can do that. You still need to mentor and work with that person going forward and you can continue to grow this business.

If you're interested in multiple clinic companies, there's somebody else that comes along and you keep finding these opportunities for them. Geography is important. Being aware of what's in the community and what the community needs are, is very important. I can tell you that the TA, Therapeutic Associates, probably turned away more opportunities than I can remember because we didn't have the right person to put in there. We knew that you can't put a subpar person in there and do well. It didn’t work.

It's interesting that those people who are trained up, know your system, are value-aligned and are highly productive and properly incentivized, geography is secondary. You could almost put them anywhere and they're going to succeed. That's the important part. I think we underestimate the importance of that training program. I don't think for most owners out there, it takes a lot to develop a leadership program of our own. It's time-intensive once we have it, but to establish the structure and say, “This is a blank PT’s leadership program and follow it.” You can put some time into polishing it up and making it better but it's the books that you read. It's the reports that you look at. It's maybe sitting in on what one-on-one meetings look like. It's showing them how someone is held accountable. Maybe if you've got some consulting or coaching in the past, sharing that same coaching or consultants, or what you've learned from them in the past and also transferring that knowledge onto them. How do you see it in developing a leadership program for these smaller owners to create?

It starts at different levels. At Therapeutic Associates, I developed robust and sophisticated certain levels and all that is because we had the numbers and we had the people. When you're a smaller organization, I still think it's important to do it. It starts with having a regular, not if you have time, scheduled meetings with those other directors so that you can discuss things. It may be HR training or it could be how to communicate better with your people and what cultural things are we trying to do to have those discussions.

The next step would be to have some classes or some organized meetings. You brought up a book. “This is a great book. Let's read it all together. Let's get together and discuss it for a couple of hours and try to understand what the author is trying to do and how that could maybe help our practice. As you get bigger, often your best teachers are already within your organization. It's not something where I'm going to bring a ton of people in from the outside to tell us how to be leaders and how to run our practice. It's good to do that once in a while to break things up. There are some great people out there that can provide insight.

From a different perspective, they can look at what you're doing and say, “You might want to try doing this or this is odd.”

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You can build it and develop it as you go. My experience has been with a lot of private practice PTs do is they get very caught up in the day-to-day and the going of their business. They can't imagine that there would be time to do this, how could you block out time to do that? My theory on that is that the time you spend now preparing for 3 to 5 years down the road exponentially is going to be much greater. You have to find the time and you have to dedicate the time. Even though it feels like, “I'm letting some revenue go by doing this.” It'll come back to you tenfold if you do it in the right way.

Sometimes we might think that leadership development is maybe a 3-month or 6-month process. As the leader in developing leadership, you need to look 1, 2, 3, even 5 years down the road and start that program. Start pushing people through and finding out if they're capable or not. Some of them might be able to reach a certain level and not go further. You need to recognize that quickly. Maybe someone is a good clinic director but it doesn't necessarily mean they're going to be a great partner in another location. You have to test, prove and show their worth in order to make those kinds of jobs.

There's no end goal in leadership. I'm still learning something every day. You keep learning. It's not like, “We're going to do this. In six months, we'll have this product.” This is not that. It's ongoing for everybody involved to continue to learn and grow. With that mindset, you'll do better.

What do owners need to be aware of as they start growing? As the number of employees increases and if they do have another location, what are some of the pitfalls that you can see that owners need to be aware of?

This isn't new information, but it's all about communication. You imagine your day-to-day in the clinic and you put your head down. You're treating your patients and you give all your energy to your patients. You're going on to the next patient or whatever, but you've got to find some time and energy to put into your staff all the time too. It can be little things. It can be things like, “What can I say to this PT aid now that they can make them feel a part of the team and make their day?” It can be going by and saying, “I appreciated how you handled Mrs. Smith when she came in this morning, and that was a difficult situation, but you handled it like a pro. Thanks for being part of the team.” That takes fifteen seconds, but it makes people feel good about what they're doing. You're building a team. You're building culture. If you can imagine, what can I do all day long every day to keep the communication strong between my team? If you let it think it's going to happen without any attention to it, it will probably not.

I wonder, as an owner, I wasn't quite sure what I would if I wasn't treating. We didn't have a lot of business training coming out of physical therapy school. If I'm not treating, what am I doing? One of those things is to check in with your team either during the course of their work or also with one-on-one meetings with those people who are a little bit more “important.” You want to stay close to your providers especially the ones close to your leadership and clinic directors. A lot of it is meetings. I'm surprised how many owners don't have regularly scheduled meetings with their billers to stay on top of their money. One-on-one meetings to help people grow. When you have leadership or people who you have tabbed for leadership, you want to take the time aside to talk with them and mentor them and maintain the communication through the company. A lot of that will help things move better, improve the flow and culture of the business as well.

We can't assume that everybody knows exactly how to do that. You, as the leader, need to help people discover those certain pieces. There's a great book that a lot of people are familiar with, written by Daniel Pink called Drive. He talks about the three things in there that motivate people. It's serving a greater purpose. It is some amount of autonomy and self-mastery. Those are the three things. As a leader, I would look at that as, “How can I help the people that are working with me identify and know what those three things are in their lives?” You can't assume that everyone says, “You may have the greater purpose of I'm going to provide all these services for my community, make my community, stronger, help the health of my community, or whatever your greater purpose is. You can't assume everybody else understands that unless you talk about it. Unless you help them identify that as well. Helping them identify those three specific areas and how you can help them develop more into those three areas will help keep your people motivated and inspired going forward.

I would even go so far as to say when you're talking about communication, that having the written systems, policies, and procedures or video examples of this is how we do things is also a form of communication that can minimize the wrong communication. Inevitably as an owner, there are plenty of people, if you're sitting in the office, that are going to knock on the door, “Do you got a minute?” and those are distractions to you as an owner. That's not the communication that you necessarily want.

Often your best teachers are already within your organization. Click To Tweet

When you have systems and procedures in place and you have given them some autonomy to come up with their own solutions without having to check in with you or redirecting them to their supervisor, instead of coming straight to you, because you're simply under the same roof, those are communication pitfalls that could crop up that need to be addressed. It can be addressed if you go through the grind and put together some policies and procedures and establish the right forms of communication.

Also, it’s not to put some of that stuff on the shelf and never look at it again. If you go through the exercise and the hard work of coming up with core values and you do a good job of making your core values an action-oriented type of core values. One of the things that you can do when you're having meetings with a group and you're talking about, “Should we do this?” You can always come back to and say, “Does this speak to our core values? Are we living our core values by doing this?” That's how you get people to understand the culture and understand the core value. How many people in a company can reel off the core values of the company they work for? If you talk about them all the time and interweaving it in the decisions you're making, it then becomes second nature. I think that's important.

What advice would you give people when it comes to the possibilities? I hate to use the word embezzlement, but as you get bigger, as more people are touching your money, and as you may become a little bit separated more from the money collections, what would you recommend to owners to stay on top of that and minimize the possibilities for a loss?

You need to come up with a few key indicators that you can look at on a weekly basis or a monthly basis, or whatever timeframe that you want to do it, and have someone to train you to understand 3 or 4 key indicators in the revenue cycle. “If this says this, we're okay. If it says something different, I need to question it.” You don't have to be an expert in billing, collections and all that stuff, but you have to know enough to ask the right questions. You have to be aware and you can't let somebody BS you. I remember a story. There's an accounting guy that sometimes I would ask a question and he would answer it. I would ask a deeper question, which made him uncomfortable. He would go into accountant speaking. He knew that wasn't my speak and how do I argue with current ratio and this and that or whatever. I was like, “I know that he’s BS-ing me. He's speaking the language that I don’t.” I'd say, “Tell me in my language. If I don't understand it in my language, then I'm going to look further.”

The mistake a lot of people make is they have somebody that they like and trust and they never pay attention. That person realizes that, “I'm a little short this month. I could borrow this and put it back in, and no one's ever going to know because he doesn't look at that detail.” One thing leads to another and you've heard all the stories. I remember that when I became the CEO of Therapeutic Associates, I was worried that I'm running this huge company and I don't have a background in finance. I was a PT. I need to know about finance.

I went and hired someone from Moss Adams to teach me the piece of finance or whatever. After about 1 or 2 hours, this woman said, “Why are you here?” I said, “I need to know this stuff.” She goes, “Are you the CFO?” I go, “No.” She goes, “Unless you're the CFO, you don't need to know this detail. Here are a few things that you need to look at and be aware of and look at trends and whatever, but you don't need to know this detail because that's not your gift. That's not what you're doing. That's not what you should be doing. You should be doing what you're good at.” It was a good lesson to me that I was getting bogged down in the weeds, trying to learn stuff and know stuff that this isn't what I'm here on Earth to do. I need to know some basics so that I can ask the right questions. If I don't get the right answers, then I look deeper.

It's timely that you brought that up because I did an interview with my business partner, Will Humphreys. We talked about some of the key statistics that you could look at with your biller to see if they're performing to an adequate level. If you go off some basic things as you talked about, then you can tell how your money flow is doing and if your bill is performing well or not. That's important. Maybe we don't have to be as specific and detailed as we may have been in the past, but we can't separate ourselves enough to not look at some of the reports that would give us key indicators as to how well we're doing and where the money is. In our situation, our biller, she had a good connection with our front desk coordinators. The front desk coordinators had a daily report sheet that they had to fill out in terms of the over the counter collections.

My biller is only responsible for insurance and patient balances. She's responsible for all collections, even the ones that come over their front desk. They had to report to the biller the front desk collections that were received. We could match that up compared to the EMR. The EMR would tell us who should have paid a copay, who has money that's owed. They could have that. That was nice to have because there was some accountability and there was even a daily reconciliation and that made us more feel more comfortable. I only met with the biller once a month, maybe once a week, if we had some issues that need to be dealt with. It was up to her then to report up to us about how collections were going and where the money was going. She also had reports that were given to me that showed her performance. I could find out quickly if she was performing well or not. It wasn't until we got to that point that we recognized greater profits in our business.

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The other thing to think about too, since we started out talking about multiple clinics, the beauty of having multiple clinics is that you can have those key indicators for each of the clinics and say if you have a spreadsheet with the 5 or 6 clinics on one side and then these key indicators. You can compare it to other clinics. That brings up things too like, “How come you're collecting this much copay at the front desk? I'm only collecting a small portion of that. What am I doing wrong? What could I do better to reach more of that level?” You have directors that can ask each other, “How come your cancellation and no-show rate is much lower than mine? What's going on here? What are you doing?” You can learn from each other. That can help with the embezzlement piece because if somebody is way off compared to the other clinics, then you can say, “Let's ask the question, why is this different?”

It's imperative to have that and compare side to side because there should be similar reimbursement rates per visit. The demographics are probably between communities if they're within driving distance. It's applicable to have those comparisons and see exactly how things are going.

It’s not that they know that they have to be the same because of what you mentioned. They can be different. You ask the question and if the answer back is appropriate and believable, then you move on. If it's the BS answer, here's a red flag. Let's check into this further.

That's the cool thing about having a leadership team is if it's a one-on-one meeting, you could probably BS me. I'm not the smartest guy around. You could probably tell a great story and I'd fall for it. When you get into a group of people, it's hard to BS a group of people. That's the cool thing. When you have a leadership team, it can start calling their peers out in a kind way. The owner coming down on that person, it's their peers that are talking to them about, “We're doing this. Why can't you do that?” That carries more weight.

That's why regular meetings are important to that group. If you never meet, then you never have an opportunity to do that. If you have a group of five or six directors, how often do you meet with that group and talk about those types of issues? I would recommend that you do it probably more often than you think you should because it's usually valuable. That quarterly, or is it monthly, or there are some people that have the ten-minute huddle on Monday morning. They do that often. There's not a secret formula that the key is that meet and learn from each other because you're going to learn faster.

It's important to commit to doing the meetings because at one point we got to a point where we had so many meetings, we recognized how many meetings and hours each month that we were spending in meetings that we had to scale back. Once we did that became powerful, but I don't we regretted the fact that we had too many meetings. At the time period in which we had all those meetings, they served their purpose. Over time, we started shrinking them down and made them more effective and powerful. The meetings worked out and we got as much done in a shorter amount of time. The pendulum swings one way, we brought it back the other way, but it all worked out well.

It depends on how big the organization is, but when you get to a certain level, as an executive in that organization, meetings, that's what you do. There are meetings. What PTs struggle with is I call it the achiever mentality. We're so oriented to checking off tasks as we do them and even our patient loads are that way. That's not a high-level leader that’s checking off boxes. A high-level leader is working within a group to make everyone in the group reach a higher level. That takes the meeting. That takes being together. You can't do that by yourself in the office with the door closed. As you get bigger, you're going to have to start doing more and more of those things because that's what makes it work.

Talking about that, we both would agree that if you're going to have a couple of clinics, you would recommend that the PT owner not be treating patients full-time. They need to be stepping out and being the leader of their companies. With that admin time, how do you recommend owners and smaller scenarios prioritize their time most effectively? What are some of the things that they should be working on? If they’re like, “I don't know what to do first so I'm going to maybe catch up on my notes and pay some bills?” What should they be prioritizing? How should they be prioritizing their time?

There's no end goal in leadership. You just keep learning. Click To Tweet

It's those touchpoints. Your greatest gift to your staff or your company in a leadership position is to grow other leaders, to help them learn and grow. Getting caught up on emails and things like that, it usually doesn't fit into that category. What you want to do is create a culture. We all know how it works. You as the owner and director, you're the most productive. You see the most patients. All the doctors want you to see their patients. We know all those things. If you develop your people and train your people, the best scenario would be that they should be busy all the time and I should have time to do the other things because that's what I'm good at.

Nothing's worse than a PT director/owner being busy all the time and the staff is not. They're sitting around doing things that aren't productive when I'm treating the patients, but I could be doing other things that would benefit the company. You have to build a culture where your people are comfortable with the fact that they're doing what they said they do and they're supposed to do. You can then maybe create more time to do the leadership things that you need to do.

Some of that is maybe hard for us to overcome. As achievers, we are the most productive and that's where our training lets us that if I treat a patient, I get reimbursement and thus we recognize our value. Our value comes from being immediately productive. I know that I treated that patient. I know I got so much money and that thus I am productive. Thus, I am this valuable. To do administrative tasks and leadership responsibilities doesn't have that immediate or obvious return on investment. It's hard for us to make that transition and recognize that acting as a leader, whether it's a strategic planning or developing processes and procedures, or following a strategic plan or creating a strategic plan for marketing or for increased productivity is equally if not more valuable than treating the patients.

You have to keep asking yourself a couple of questions. One is, “Am I following through on my gift doing what I'm doing?” If you're starting a practice and you're building your reputation or whatever, then it's legitimate to say, “Yes, I'm treating all the patients. I'm being productive. I'm building up whatever.” That’s fine, but you have to go down the road and say, “Am I using the highest level of my pay grade,” if you think of it that way. There are other people that could be doing some of these things that maybe I'm spending my time.

The second question I would always ask myself is, is this sustainable? If I'm being that productive, being overwhelmed and whatever is this sustainable over the long run. We've all had situations where let's say our superstar PT is out on maternity leave for three months. We can gear up, treat more patients and do more things during those three months waiting for that person to come back. That has a start and endpoint, but I see a lot of PTs get to the point where they're on the treadmill. If they ask themselves that question, “Is this sustainable?” The answer's probably no. If you answer no to that question, you've got to find a different strategy. You've got to find another way to do things.

I've shared this story before that for the first ten years of owning a practice, people would ask me how the business is going. I'd say, “I love treating patients, but I hate running a business.” It's the HR and all that stuff that I hated doing. It wasn't until I changed my intentions and recognize that I truly was the owner. If things were going to change my business, it was up to me to change it because I was at number one. Until I set aside time to work on my business, that I see the change and the growth in my company, and also a change in myself where I started enjoying owning a business. I found value and a lot of pride in improving the business aspect of my company. It grew because of that. The people who worked with me and for me also grew as well as I took that helm and became a leader of the company. It made a change.

Most of our peers go through that at some point. The other option would be I love treating patients. I love doing this. This is my gift. This is what I do. You have to hire a business person then to do the business side. Some people may be comfortable with that and a lot aren't. That's the other alternative, but you can't do it all usually and be successful. It gets back to The E-Myth thing. You have to also work on your company, not just in your company.

Even if you brought on a business person, you still have to have meetings with them. You have to train them on how you do things and what your expectations are. A lot of times we might think that we're delegating when in some aspects we're advocating and not appropriately following up. That's something we have to recognize as leaders is that when we delegate and when we train people up, the next step is to follow-up and make sure that they're following the policies, procedures and systems that we established and cheering them on. Not abdicate that thinking that they're trained and they're ready to go.

PTO 114 | Managing Multiple Clinics
Managing Multiple Clinics: A high-level leader works within a group to make everyone in the group reach a higher level.


You always got to pay attention to.

Is there anything else you want to share about multi-clinic ownership that maybe we didn't cover that comes to mind?

My career was in a company that had multi-sites. I believe in that concept. If you have a very specific niche or you're very aware of what your goals and intentions are, having one stand-alone clinic can work. I think from a business perspective that it's easier to do exciting and important things when you're bigger. You can get through situations easier because you've got some support. When one clinic is down for whatever reason, you've got others to support it. If you work together as a team and me personally, again, it's a personality thing, but I find a lot more joy when I'm working with a group of people, as opposed to working on my own.

There are some real advantages to it. You have to decide at what level you want to do it. If you want to build a legacy type company, then my feeling is you probably have to get to give some ownership pieces in there and some governance roles in there for other directors. You want to hire someone like yourself, who has your motivation and inspiration and dedication but if you don't give that person the right incentives, they are then going to say, “What am I doing here? I'll go and do my own thing. I'll go with somebody who appreciates that.” You’ve got to give up a piece of the pie, in my opinion, to enjoy the fruits of the bigger pie.

I'm glad that you brought that up because I've recognized the same thing. Those same guys that have been successful with multiple clinics are the guys that not only had leadership development and found and developed the next partner in their company. They've also incentivized or at least given some profit sharing, equity sharing in that clinic to help them feel like they own something. It’s like they're a part of something bigger and that can be incentivizing, but inevitably those companies that have those kinds of structures have done well and are some of the more successful ones that I know of.

An ownership mentality is everything. Click To Tweet

An ownership mentality is everything. It doesn't have to be exact ownership, but you need to develop that ownership mentality. You want that director to feel like this is their thing and it depends on them. The success and failure of this are going to be about them. You need that. I'm not a fan of having two partners in the same clinic. I think that causes problems. I don't care how good a friend you are, whatever, but somewhere down the road, there's always one partner that thinks that they're working harder than the other one. They're doing more of this stuff and whatever and it causes problems. If you're at a clinic by yourself as that leader, you don't have those tensions as much, and then you still have the benefit of working with others being in a bigger group. That's why I like the multiple clinic style. There's so much opportunity out there. If you're good at what you do, why not spread it around to more people.

That's the definition of power. It is the ability to influence more people with the same amount of work. If you can be as influential as a physical therapist, treating patients one-on-one, but now you can treat thousands of patients through multiple clinics, then you're that much more powerful. Everyone wants to have a greater impact on their community, their surroundings and their environment. That's why we did it in the first place. Thanks for your time, Steve. I appreciate it. You're doing some great work or you have been in the PPS and Peer2Peer. Thanks for your efforts in that. If people wanted to reach out to you individually, how would they do that?

I'm happy to give my contact information. My email address is My phone number is (206) 683-5051. You can also go to my website, There's a place in there that you could reach out to me on that website as well. Many of those things, I'd be happy to talk to anyone and help them.

Thanks for your hard work. Thanks for your time. I appreciate it.

Thank you, Nathan. I appreciate it.

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About Steve Anderson

PTO 114 | Managing Multiple Clinics

Steve Anderson is the former CEO of Therapeutic Associates, a physical therapy practice with more than 80 outpatient clinics in Washington, Oregon and Idaho that also serves as a major hospital contract in Southern California. Therapeutic Associates was formed in 1952, and Steve was only the 3rd CEO and held that position for 19 years, beginning in 1998 after 16 years with the company.

In addition to his day-to-day responsibilities, Steve is also active in national organizations related to physical therapy, including the American Physical Therapy Association (APTA) and as a Board of Trustee for The Foundation for Physical Therapy. He also served as the President of The Private Practice Section of APTA for 6 years between 2002 and 2008. He received his section’s most prestigious award, the Robert G. Dicus Service Award, in 2010.

Steve received the APTA Leadership Advocacy Award in 2006 for his efforts in Washington D.C. and Washington State in the legislative arena. In 2012 Steve received the Distinguished Alumnus Award from Northwestern University Physical Therapy School. In 2016 Steve was awarded Physical Therapist of the Year by PTWA, the APTA chapter for the state of Washington.

Steve earned his bachelor’s degree from Pacific Lutheran University. He went onto physical therapy school at Northwestern University in Chicago. He has been a physical therapist since 1980 and worked for Therapeutic Associates until the end of 2016. He resides in Seattle, Washington with his wife, Sharon.

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PTO 29 | Recruiting Top Talent


Sabrina Starling, PhD, PCC, BCC, wrote the book on how to find the top talent to join your team, literally. After noticing that recruiting and hiring "A" players was exponentially more difficult in rural settings she decided to write the book on it - How to Hire the Best (available on Amazon). She has worked with a number of physical therapy owners in the past and has recognized some of our pitfalls. She shares with us how we can get out of our own way and hire the most talented people to share our visions and join our teams. A number of factors are at play, and she goes through them all, greasing the wheels on capturing top talent will pay off in spades - productivity, culture, profits, stress (relief), growth, etc. Spend a few hours a week and the difference will be felt for years.


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How to Recruit Top Talent with Dr. Sabrina Starling

PTO 29 | Recruiting Top Talent
How to Hire the Best: The Rural Business Owner’s Ultimate Guide to Attracting Top Performing Employees

In this episode, I get the opportunity to talk to Dr. Sabrina Starling about recruiting and attracting top talent to your company. Dr. Sabrina Starling 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. Dr. Starling's How to Hire the Best series grew from a desire to solve the toughest hiring challenges interfering with her clients' growth and profitability. She was a business coach in a rural setting and had small-town entrepreneurs looking for top talent. What sprang from her experience working with entrepreneurs in rural areas catapulted her into becoming a world's leading expert in attracting top talent in small businesses. It has earned Tap The Potential the reputation as the go-to resource for entrepreneurs committed to creating great places to work.

Tap The Potential specializes in transforming small businesses into such profitable great places to work that they celebrate by sending their business owners on a four-week vacation to celebrate their accomplishment. You can't do that unless you're leaving behind the top talent to run your businesses. With Dr. Starling's background in psychology and years of driving profit for small businesses, she knows what it takes to find, keep, and get exceptional performance out of your biggest investment and that is your team members. She also does a weekly podcast called Profit by Design and she and her co-host, Mike Bruno, can bring you tips, tools, and strategies to grow a sustainably profitable business that allows you to live the lifestyle you deserve.

Take a read to this episode regarding recruiting top talent, A-players but follow-up on my next episode. I'm going to talk with Dr. Starling and Jeff McMenamy, a friend of mine, a therapist in Wyoming who is thriving and has multiple practices. Look out for that episode because we're going to talk a little bit also about the support that a coach can provide a business owner, specifically, Jeff, in his case. He has been working with Dr. Sabrina Starling to improve his capabilities as a leader and owner of his physical therapy practices. In this episode, we're going to focus specifically on Dr. Starling's experience, her book, How to Hire the Best, which also has a corresponding website, and we'll talk about attracting and recruiting top talent.


I'm talking to Dr. Sabrina Starling and I'm interested to bring her onto the podcast because of her insight specifically about attracting, recruiting top talent. Also, she's an expert on it. She has a book about it. She will explain to us a little bit about that, but how that also leads to improving profits and improving lifestyle. Before we get into that, thank you for joining me, Dr. Starling.

Thank you, Nathan. I'm so excited to be here and talking to your audience about this very important topic.

All of us struggle with attracting and recruiting top talent. That might be the most important word, top talent. We can always find someone off Craigslist or something like that, but to get the top talent into our office and become a team member is essential. It's something that I don't think a lot of us focus on as physical therapy owners. We might hire out to recruiting firms or do our best with social media and Craigslist or something like that, but I'm anxious to bring you on to talk about how we can do it ourselves. What it necessarily takes to attract them and recruit those top physical therapists, top office staff or top executive team members. Before we do that, Dr. Starling, do you mind sharing a little bit about you and how you got into your profession, where you're at right now and your experience with physical therapists?

I am a psychologist by training and I was working in a rural mental health clinic out in the middle of Wyoming where there's more antelope than people. I got very burnt out in just delivering therapy services to severely mentally ill people. I thought “I want to work with people who are healthier” and that was years ago and that was when life coaching was fairly new. I started learning about becoming a life coach and I thought, "Here's my path. I'm going to become a life coach and I want to help people with work-life balance." I have a lot of clients seeking me out for work-life balance and the majority of them turned out to be small business owners. As I was taking into things with them, I was realizing they don't have a work-life balance problem. They would love to be taking vacations and spending more time with their family. These are not people who I would have to twist their arms to do that. What they had is a team problem. They had the lack of the team that they needed and because of that, they were working hard in the business themselves.

For years I just accepted, we're in a small town, this is a rural area. Because we're in a rural area, we can't get good help, we can't attract good talent. We just have to make do. As a psychologist, a lot of my clients were asking me to help them coach their team members, to take their warm body team members and make them into top performing employees. "Surely, we could use some good psychology on them, Sabrina. Make them work harder and be more engaged and be more excited about work." That was like pushing a boulder uphill. The results that we got from that effort were so negligible. It was not worth it. Here's the other thing that I saw going on is I saw business owners passing on growth opportunities and that hurts me at my core. I'm an entrepreneur at my core, I cannot pass on a growth opportunity.

Bringing people in and experiencing turnover is a slow kiss of death for a small business. Click To Tweet

Tell me about that a little bit. Number one, it's amazing that you're here, that you spend all that energy. You have this background in psychology and you're trying to help these people improve and that was like pushing a boulder up the hill of these very sluggish people. I want to note that for the audience, here's a trained psychologist that was trying to get people who didn't go anywhere to go somewhere. It didn't work. Tell me a little bit about some of the opportunities that you noticed were being missed.

I saw business owners looking at, for example, a physical therapy business. I've outgrown my space. I have the opportunity to grow, but that's going to mean that I have to hire people. If we take on more, I'm already working 60 or 70 hours a week myself. If we grow and I can't get the team that I need, then it's going to be me doing that work and now it's all on my shoulders. Now, I'm working 90 hours a week. That's not sustainable. Instead of growing, they would choose to stay small. It was when I woke up and you have those thoughts as you transition from sleep to wakefulness. Sometimes you have bright ideas and I happened to have a bright idea. That moment this question went through my head of, "What if it's not true?”

I was thinking about, "What if it's not true that because we're in a small town in a rural area, you can't get good talent? What if there are business owners who have top talent in their business and they're in rural areas? If those people exist, maybe they know something. If I interview them, maybe I can find out what they know, and I can share it with all the business owners I'm trying to help." That put me on a quest like, “I'm going to figure this out.” I started looking around. I went to books. I love to read so I started looking for business books. Are there any books out there on hiring talent in small business? There are books out there on hiring talent, but they're geared to corporations, larger entities, businesses that have an entire HR department. They're not there for the small business owner who's still wearing a lot of hats themselves in the business. I thought, "There's no book out there. Maybe there are some business experts I could interview who could point me in the right direction."

One after another, I interviewed entrepreneurial thought leaders and they kept saying, "It's a need out there and no one's addressing it." That's when I thought, "I'm going to solve this problem. I'm going to figure this out." I started talking to small business owners who had some great employees on their team and nobody told me, "I'm happy to talk to you. I know exactly what I did, and I want to share it with you." They all said to me a variation of this, "I'll talk to you if you need to talk to me, but I have no idea how I got these people on my team. I'm grateful I have them. If you find out the solution, the answer to this big question, please come back and tell me because I don't know what I'm doing either." I thought, "I've bitten off more than I can chew. I'm not going to be able to solve this problem."

As I interviewed one business owner after another and I asked them to tell me the story about this great team member that you have on your team, they all kept giving me a variation of the same story. It came down to good networking. I thought, "Isn't this interesting? We all are doing this good networking, but no one is claiming it as a system. No one's looking at putting a system in place in their business to attract more great team members like the couple that they have. What would happen if we got more intentional about this and more systematic about it?" That's how my book, How to Hire the Best was born.

That's cool to hear because you don't talk a lot about networking to find your top talent, but when you think about it, the A-talent out there, the top performers, they hang around each other. When you have a lot of B and C-players on your team the A-players won't stick around. They're feeling like they're getting dragged down or they're not meeting what their expectations and their performance as well as the company's performance. What a great perspective to come from is that if you can tap into those A-level performers from a networking standpoint, they're going to be able to direct you to other A-performers.

Being mindful of not having a team full of warm bodies. My saying about that is if you have warm bodies on your team, you might as well be spraying A-player repellent all over your business because they don't want to come and hang around. If you are intentionally working on creating a great place to work, all of a sudden now you're positioning the business to attract A-players. If you intentionally network and you have a great place to work, all of a sudden what felt like it was this impossible problem to solve, how do you get talent to your team? All of a sudden now you have a steady pipeline of people who are waiting for the opportunity to work for you and that's the ideal place to be.

PTO 29 | Recruiting Top Talent
Recruiting Top Talent: Having these core values in hand as you start to recruit is absolutely essential because one of the things that many PT clinic owners do is they go looking for skill set.


When you have A-team players waiting on the bench to come and join your team. The type of people who say, "If you ever have an opening, please let me know," then that's the ideal situation. From our personal experience, my business partner, Will Humphreys, focused on recruiting some physical therapy schools and the students coming out of there. He spent a couple of years honing that and improving the business at the same time so that once he got a couple of those A-type students, those top of the class students to come and join the company, they invited their closest friends to come join the company as well. It changed the dynamic when it comes to recruiting. In that we're able to create a culture and develop a network. By doing so, hiring those A-players and fulfilling our promises led to them spreading the word and getting other A-players that were coming out of school to come and join us as well.

Then it all starts to flow, and I want to give a shout out too because when I wrote my book How to Hire the Best, I wrote it for small business owners in rural areas and I was working with different small business owners. One of them is a physical therapy owner and we were trying to figure out. He was struggling, and he needed to recruit some PTs and OTs. In a rural area, there's no college around within an easy drive where they are pumping out students. What do you do? How do you get these folks? We had to get creative and that's where I started to learn myself thinking about recruiting talent. Just like you think about marketing to attract your patients to your business. If you do a spray and pray marketing approach, you're going to get patients of all different varieties. They're not going to put in the best patients. You're not going to enjoy working with them. They're not going to succeed. They're not going to do their exercises and the follow-up that they need to do to recover. To grow a successful clinic or multiple clinics, you have to have a focused marketing strategy. The same happens when it comes to attracting talent. You need to have focus on it, intention, and strategy behind it, then systematize.

Can you share with us a couple of strategies that you've used in the past to recruit?

First off, just like marketing, when you're trying to attract patients, you have an avatar of a type of patient that your company is best suited to serve. When it comes to recruiting, we want to have an avatar of our ideal employee. If you look at the team members that you've had in your business or that you've had in the past who have worked well and fit well in your business, what qualities do they have? What are they like? Understanding that typically just like in marketing, the patients who are most drawn to you and who want to be a part of your business and work with you, they're coming because they have core values in common with you. There are some common threads. That applies when it comes to recruiting also. If you look out at your best team members, what are those core values of yours that they share? The core values are the glue.

For some business owners, we're starting at the ground level in identifying what are those core values because those are the foundations of your culture in your business. Your personal core values as the business owner are what drives the culture. Sometimes business owners will say, "I don't know what my core values are. Maybe I'll have a team meeting and I'll ask my team what our core values are." Please don't try that approach, especially if you have warm bodies on your team. This is a self-reflective approach. You have to reflect on your core values and make those into the immutable laws of the business. If you have readers who are just starting to think about this, a simple way to start identifying your core values are two questions. What's made you proud lately in the business and what's ticked you off lately in the business? The things that have made you proud point to your core values.

When we're proud of something, it's because they align with our core values. My daughter went with into her school and they helped out at the food bank. I am proud of that and that's one of our core values at Tap the Potential, be a gift from your gifts. We use our gifts to serve our clients and in our greater communities. I feel proud of her because she's being a gift from her gifts. That's one way to identify core values. Then the next way is to look into what's ticked you off recently. One of the things that ticks me off is poor service and I experienced poor service from a business. I think, "They're not doing what they said they were going to do. They told me they were going to do one thing, they did another." My number one immutable law is, "You can count on us. We do what we say we're going to do.”

Notice this is all in my language because I'm talking about my business. These things I'm saying may resonate with you, but you may have a different way of expressing those things. You want to narrow down your core values into your own language and use common language and common phrasing. Then at that point, you go to your team and say, "Here's the core values I'm coming up with for the business. Tell me how do these relate to you and how do they hit home for you?" Then just watch around the room as you share. Some people will be smiling, eyes lighting up, leaning forward in their seat. Other people leaning back like, "Really?" arms crossed, that's not a good sign. They're probably not going to be with you long. What you're doing is you're calling out they're not a good fit, and now it's becoming obvious why they're not a good fit.

A-players are hardly ever unemployed. Click To Tweet

Having these core values in hand as you start to recruit is absolutely essential because one of the things that many PT clinic owners do is they go looking for skill set. If someone has the degree, they've passed the round one of qualification. That’s not right. What we do is we want to hire people who are a great fit for our culture. Then look at do they have the qualifications for the job because if someone has the qualifications but they are not a good fit for your culture, they're going to become a cancer in your culture. That's going to be the person that you interview. They look good on paper. They talk a good talk. Talk a good game in the interview, but you get them in your business and a few weeks later you're going to be beating your head against the wall because they drive you crazy with the choices and the way they do things. It's not about skill set. The first criteria needs to be fit with your culture.

That's the conundrum of physical therapy owners that are in small towns is that it's hard enough to get someone to come to your town because you're in a small town. When you narrow it down to someone that needs to have a PT license and they are willing to move to a small town, then you're thinking, "They're at least willing to come here. They're a warm body. That helps me change some temporary goals." Can you speak to the loss that's incurred when you get a poison on your team?

It costs thousands of dollars of your time, your effort to interview, to recruit them. You get them on. You train them. You start investing that way. The turnover, the best thing that can happen to somebody only stays a week, the worst thing is they stay three months and then the rest of your good employees get totally frustrated. They start losing faith in you and so you risk losing your great employees too. Bringing those people in and experiencing turnover, it's this slow kiss of death for a small business to do that. You mentioned small towns. You're in Alaska, I used to live in Wyoming. There's a phenomenon that goes on. You get a guy who wants to move to Alaska or he wants to move to Wyoming because the great outdoors and all the fishing and the hunting, but the wife not so much. You sell him hard to come and it's a great place to live. He is going to be totally happy, but if you don't take into context his entire life and if he's bringing a family with him, he's not going to stick. He may be a great fit culture-wise for your business. He may have the skill set, but if he's leaving in a few months because his wife is miserable, that's costing you a lot too.

How do you overcome that?

It goes back to one great strategy is recruiting from schools and developing those relationships with the academic departments. As you're doing that, being clear about the culture and your workplace and what makes your business unique compared to all the other options that students have. You just want the right people to pay attention and you want to say enough about what makes you unique and what your culture is like so that the wrong people just say, "I'm not interested," and don't even take up any of your time. The problem is when we're desperate to hire, we are out there trying to sell our business to somebody and make it sound like, "It's the best place ever and you're going to love it for this reason or that reason. I know your wife, she wants the shopping malls. There's one an hour and a half from us." Just being straight up honest, "This is probably not going to be a good fit for you," and then go onto the next person and talk to the next person. Don't keep trying to sell somebody because ultimately, if you create a great culture and a great place to work around your core values and you attract like-minded folks, your turnover is going to be low. You are not going to need twenty applicants a year for two positions. You are just going to need two or three applicants for each position and then you get to pick.

You talked a little bit about intention and I want to know your thoughts about the intention when it comes to recruiting and hiring. What do you mean by intention and how do you explain that?

Most of us, business owners, don't start thinking about hiring until we're desperate. We put it off as long as we can because we know it's going to be a long arduous process and at that point, it's already too late. We're having to resort to desperate measures. If you start at the point where you have a steady lead generation in your business. You’ve figured that piece out like how do you get lots of patients coming through the door, how do you get those referrals going from the doctors and how do you get the right doctors referring the right patients to you? You've got all that figured out, the next thing that you're going to be looking at is a capacity issue.

PTO 29 | Recruiting Top Talent
Recruiting Top Talent: When we work from our strengths, we are 900% to 1200% more productive than when we work from our Achilles heels.


That's where if you start at the point where you have good conversion, lots of good patient flow coming through the doors and then you start thinking about, "If my business grows at the pace that it's been growing, how many team members am I going to need in the next year to three years?" Then start being intentional around how you're going to recruit those team members and put just as much priority on that as you put on marketing. Then you're going to be in a much better place. You're not going to be at a point of desperation trying to just take anybody that will sign on with you.

This is a common problem I'm sure you see across the board in that the small business owner, in our case, the physical therapy clinic owner maybe doesn't take the time to look one to three years ahead. Is that a common issue? 

You're wearing so many hats and you're juggling so many responsibilities and then thinking about recruiting, it feels like, "That's just one more thing I've got to think about." In reality, it doesn't take a lot of effort from week to week as long as you are intentional about it and you recognize it is a priority. "I need to be starting to think through who are our ideal employee is going to be and where are we going to get them from, what pool?” Every physical therapy clinic has a pool of places to get their ideal employees from, you just have to discover it.

If a physical therapy clinic owner came to you and they're in a bind. They're a small business and you've been through this before. They need to bring on a physical therapist, but they're in a small town, their backs against the wall. I'm working 60 hours a week. What's the first step? How do you coach them to take the first step to move along in the process?

It goes back to identifying the qualities that you need in a team member and your values. The piece that I haven't spoken enough to is the qualities that you need in an ideal team member. You have to identify the roles that you're going to need to fill in your business in the next one to three years, the key results from each of those roles that will drive the profit of the business. What does each position produce and how does it relate to profitability? Then you want to think about what qualities, what personality strikes does someone need to have to produce that result exceptionally well, day in and day out? A prime example of this is someone at your front desk, they deal with a lot of people and they manage a lot of details. That is somebody who needs to be a people person who's detail-oriented. They need to be energized by dealing with people.

If you put an introvert who's great at managing details and who's smiling and can be friendly. If you put them at your front desk and you need consistent, exceptional performance from them day in and day out, they're going to be flagging a bit, burnout because they're not operating from a strength. When we work from our strengths, we are 900% to 1200% more productive than when we work from our Achilles heels. Somebody who needs a job and they're an introvert and they want your front desk position, they may tell you, "I like people. People are great," but every day they are going home from work and they're zoning out in front of the TV because they are totally wiped out by all that interaction. If you hire an extrovert who's great at managing details, now you have the right person at your front desk. They're energized by that work and they're getting more and more productive every single day because their energy goes up from what they're doing.

They want to talk to people and that goes back to what is the ideal employee? Because when we post an ad or when we throw it out there on social media, we just typically list the bare minimums. If you can type, if you know how to work in Excel, if you can schedule a patient, then you're qualified and you're just checking off the boxes. Instead of putting an ad out that says, "This is the personality type that we want, and they've got to be energized by talking to people. They've got to be excited about meeting people and disappointed when people don't show up. They have a belief that what physical therapy is doing is the thing that they need to do in order to attract the patients back in and make the difficult calls." Putting an ad out like that can filter out a lot of the candidates pretty quickly to get you to the ideal candidate.

A-players are a joy to lead and manage. They're enthusiastic about the why of the business, the vision, and the mission. Click To Tweet

When someone reads it who is not a great fit, they need to read it and say, "I would hate that job," so they don't even apply. Then you're saving yourself a lot of time, but the other reason that identifying the personality strengths that someone needs to do the job exceptionally well, day in and day out. The other reason why that's so important is that when you're networking and let's say you're at a party like the holidays are coming up. You're at a Christmas party and you're talking to somebody that you've just been introduced to. You're telling them about your clinic and you say, "I am looking to be introduced to someone who is outgoing. They love people and they're great at managing details. Who do you know who's like that who comes to mind?" All of a sudden now real faces are popping into that other person's head. Notice I did not say, "Who do you know like that who is looking for work?"

Because the other thing is that A-players are hardly ever unemployed. Our traditional way of finding people to fill the roles in our businesses is to put an ad out there, to post on Craigslist, Indeed or Monster and just assume that the right people are going to show up, but A-players are not out there looking. They're working elsewhere. When you're networking, you want to ask, "Who do you know who's like that," and give a good description and say, "Would you be willing to introduce me to them? Would you make an introduction?" You're not even talking about that you have a job opportunity in your clinic. You're just saying, "Would you be willing to make an introduction?" That's how you start to build your network of A-players for the different roles in your businesses. Back in the day, we would have Rolodexes. You would imagine you would take that name down and put it in your Rolodex file and that went away for the next time we have a front desk opening, I'm going to call them.

You want to have some database that you're keeping when you're collecting information about these people. You want to get into conversations with them and say, "So and so told me about you. They spoke so highly of you about how you love people and how great you are at managing details. I just wanted to share with you a little bit about what it's like to work for us and not necessarily now, but maybe sometime in the future if you're ever looking for an opportunity, you want to circle around to us and see what we have available." Then you're also doing a little bit of screening in that conversation because you're gauging their energy level.

You might share a couple of stories about your values and see how they respond and see if they are resonating. If it's all checking out, you're saying, "I would love to stay in touch with you. Would you mind if I add you to our newsletter, so you can learn more about our clinics and when we have openings we'll be posting it in our newsletter?" Now you have a way of staying in touch with them. They're curious. They're so flattered that they've been referred to you and you've connected with them. You've started to build a relationship and now you're starting to create a system for staying in touch with people so that you have a steady pipeline of A-players when you have positions to fill.

That takes so much stress off of the owner. When someone turns in their two or four-week notice, whatever it might be you say, "We're going to start. I know where to go first. It's not like you're starting from ground zero. I'm going to start making the calls." Hopefully, you've got one or two people in line for whatever position it is, and that's the ideal situation. It is to get to that point so that hiring and recruiting is like the pinnacle of your company because it leads to so many other things. I'm glad you brought it up that it all ties back to profitability. Each position has a product that lends to profitability. That goes to show when you get A-players and have a system in place for recruiting and attracting and retaining A-players that all suddenly leads to improved profitability.

Payroll is the biggest expense in a small business. If you have warm bodies on your payroll, you have a lot of expenses. That's a big profit bleed like money's just going out the door, but if you have a lot of turnover, that's impacting the profitability of the business. If you can nail it down to, "These are the results that I need from the roles that I have," and then you bring in people who have the strengths and can deliver on those results, you will see the profit in the business going up and up from that. I am a firm believer in it's not about revenue, it's about profit. It's not about what comes into the business. It's about what the entrepreneur gets to keep and how that entrepreneur is rewarded for their risks that they're bearing as an entrepreneur.

We talked about profits. What are some of the other benefits to that? They're self-evident, but what have you noticed in your experience as you've helped people improve their recruiting and attraction methods?

PTO 29 | Recruiting Top Talent
Recruiting Top Talent: Offering internships is a great way to screen people. You pay them relatively low and you get to see firsthand how they perform and how good of a fit they are.


Going back to my story that I told about how I got into this. I didn't start out wanting to be the small business hiring expert. That's where I landed, but it was by accident. What I was trying to do was help some of these business owners take a vacation like they're so overworked. I would say, "You're so fried. Just take the weekend off, you need a vacation," and they would all give me a pushback, "I cannot. Who's going to get the work done if I'm not here? I need to be in the clinic. I need to be doing the emails myself because if I don't do it, who's going to do it?" The biggest benefit of hiring great team members is that you, the business owner, have people that you can trust to handle things in your absence. When you combine great team members with strong systems in your clinics, you don't have to be the one in there doing all the work yourself. You can be away from the business, things can run in your absence and you can have some peace in your life.

That’s one of my biggest concerns when I was starting off as a physical therapy owner in the beginning years. I remember telling all my friends and family, they say, "How's the business going?" I said, "I love doing the physical therapy, I just hate managing the people and all that comes with managing the business." I found that as we attracted and hired more people and helped them with the systems and train them appropriately, things became a lot easier. Now as I go back to treating, I don't get as much fulfillment from that unfortunately, but I get excited about creating something bigger. 

A-players are a joy to lead and manage. They're full of energy, they are passionate. They're enthusiastic about the why of the business, the vision, the mission, and it feels like we're all in this together. We're working towards a larger goal. Then I can teach the business owners and the managers in the business some coaching skills and it's like dropping a tomato seed into fertile soil. The tomato plant grows and it produces a lot of tomatoes and you just had to put some water on it. It wasn't a lot of effort. If you are trying to do that same amount of effort with a bunch of warm bodies, it is draining. For your audience who are feeling like, "Nathan hit the nail on the head. I like treating. I don't like dealing with and managing people. I just want to treat all the time." Look around at who you're trying to manage and be honest with are they A-players? Are they the type of team members that I want and is that the problem?

I love the question not to backtrack too much, but the question that you put out in the very beginning, what if it's not true? When we have these fixed ideas, what if they weren't true? What if recruiting in a small town isn't difficult? What if you just flipped in there and said, "Recruiting in a small town is easy because there are tons of people who would love the small-town lifestyle, especially in the wilderness of Wyoming or Alaska, you name it." What if it's not true? Then when you asked that question, and I'm sure you've done it millions of times as a psychologist, it unlocks a lot of thoughts and ideas that can come forth at that point and lead to further action.

I want to throw out one other little ninja strategy that your PT owners can take advantage of and that is offering internships in your clinics. Because what better way to screen people than pay them relatively low and they come and work for you and you get to see firsthand how they perform and how good of a fit they are. It's also a great opportunity to woo them if they are a great fit because now, they're making connections and friends in the clinic and they want to stay.

A lot of the more successful physical therapy clinics out there, even from my own experience in my graduating class, 75% of the people that had jobs, were jobs that they had from the internships that they did. It makes it so easy and you have no commitment to them. That's why if they don't work out then we're obligated to let you go.

Those department heads, when you successfully employ their students over and over, it makes them look good because they're able to say, "We're able to place X percentage of our students in jobs and they stay in those jobs. They're happy." That's creating a win-win situation.

Everyone has something that they can contribute that further somebody else on their journey. Click To Tweet

Dr. Starling, what's the name of your book?

How to Hire the Best.

I'll have people reach out and look for that. Is it on Amazon?

It is available on Amazon. If you want to get my masterclass, which is a free masterclass where I go more in-depth into how you build your A-player attraction system. You can get that at

Can they also order the book there?

You can order the book from Amazon.

If people wanted to reach out to you directly, what's your availability there?

The best place to find me is at my coaching company,

Thank you so much for your time. Is there anything else you'd like to share with us?

If you want to hear more about building a sustainably profitable business to support you and the lack of style you desire, we have a podcast called the Profit By Design podcast. You can find that or whatever platform you listen to podcasts on.

I was a guest on it. It was a lot of fun and I love it. I asked you beforehand, how you describe your podcast and it's all about building a sustainable, profitable business to allow you to lead the lifestyle of your choice essentially. As small business owners, we're all looking for that.

I love bringing on guests like you, Nathan, and hearing their stories and just learn from each other as entrepreneurs. Everyone has something that they can contribute that further somebody else on their journey.

We're going to have a follow-up podcast here with you and one of your clients from the past. I invite all to look out for another podcast where Dr. Starling and I are going to talk with Jeff McMenamy of Teton Physical Therapy. He’s someone that's worked with Sabrina in the past and share his experience in working and growing from a small business that was having a lot of the small business issues that you were talking about and now being completely successful, profitable, and living a lifestyle by choice.

I'm looking forward to that conversation.

Thanks for joining me. I appreciate it.

Thank you, Nathan.

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About Dr. Sabrina Starling

PTO 29 | Recruiting Top Talent

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.

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