PTO 120 | Patient Retention And Referrals

No matter how good you are at physical therapy, there is one thing that will turn your patients into raving fans or active detractors, and that is the service they receive from your team. Customer service is probably something most owners would consider an inherent plus in their clinics, but how often do they take the time to train, role-play, and focus on improving the customer experience? If it's not continually improving, we'll assume that it's gradually declining. Dr. Kelly Henry joins Nathan Shields to bring his insight as an executive coach to the podcast to discuss the keys to ensuring a great customer experience, and the benefits of intentionally working on it to multiply your profits.


Listen to the podcast here:

The Key To Patient Retention And Referrals With Kelly Henry, DC

In this episode, I have Dr. Kelly Henry, a chiropractor who's living in Texas. He had grown a successful chiropractic business for many years. He's now an executive coach. I'm excited to have him on the program to talk a little bit about customer service and its importance in our practices and what it can do for us. First of all, Dr. Kelly Henry, thanks for coming on. I appreciate it.

Thank you, Nathan. I appreciate the opportunity. Thanks for having me.

You might be the first chiropractor I've ever had on the show, but there's a lot that we share in terms of the business aspect of our practices. It's great to have you on. I know you've been working with some physical therapists in your coaching business. Tell us a little bit first about where you came from and what got you to the point that you are now.

My story is maybe similar to a lot of other chiropractors and physical therapists. I got out of school and I thought I knew everything. I thought I knew how to run a business. I thought that I open the doors and I was going to be tremendously successful. Things turned out otherwise. I got out of school at Dallas Parker Chiropractic College. I moved to Phoenix with my wife and with our one daughter. Fortunately, I got into practice with several other chiropractors. We each had our own practices. If you know Phoenix, as far as a physical therapist, it has a chiropractor in about every corner of the streets. There is a lot of competition. I was very naive and I did not do well at all. There is not much money at all.

Fortunately, the doctors I was with in that particular clinic, there were a couple of older doctors that had been in practice for 15, 20 years. I gained a ton of knowledge from them, not necessarily experience. I hardly make any money. It’s very frustrating times. Looking back, it was tough but I appreciate what I have now because of what I went through then. I was there for roughly a year. I got a call from a chiropractor that I had met in New Mexico where my wife was from. He was retiring and wanting to know if I wanted to buy him out.

I was fortunate enough to come up with some financing and do some things to be able to buy him out. I moved to New Mexico. I did okay. I was doing better than Phoenix, which is not saying much, but it still wasn't to my expectations of what I needed. I struggled on for a few years and finally got with a coach and that's when my career took off. I was able to get a great coach and coaching system to implement as far as the management side in my office. I steadily grew from there. I outgrew that coach. I was with another coaching and consulting firm. They helped me get to another level and I outgrew them, and it kept going on and on.

Finally, I got with another coach and blew up from there. After about 10, 15 years of that, I developed my own systems taking pieces of all the coaching that I had and ran that. I had two locations so I was able to grow my office. I had a satellite location with another chiropractor. I was able to sell those all out in 2018 and then turned my attention to executive coaching and coaching of chiropractors and other industries in the ways of customer service. That was the bedrock of how I was able to grow my businesses on the foundation of great customer service that helped me to retain patients. It’s what the key was.

Your story isn't all that different from most physical therapists that we talked to. We don't get a lot of business education in PT school and I figure it's the same in chiropractic. Once we get some of that technical knowledge in terms of how to run a business, and that's what I'm sure you got from your coaches, that's when things tend to turn. That's one of the keys to the success of the PT owners that I’ve interviewed that are successful. It takes some time for them to hit rock bottom or start getting burned out before they finally turn to a coach and someone who might know more before they start to see improvement. Part of the show here is to tell them, "Don't wait until then.”

Based on a Harvard Business Review study, improving the customer experience can increase your PROFITS between 25-90%! Click To Tweet

You're going to save yourself a ton of time and money if you'll swallow your pride and work with somebody that might know what they're doing to help you grow your business quicker. It's funny you say that because a lot of times I'm very leery of working with docs that are out of school for only 1 to 2 years. What I say is they don't know enough to know what they don't know, to know that they might need a coach. As you said, they hit rock bottom, life and business slap them in the face to say, “You don't know what you're doing that they say, ‘I do need some coaching.’”

What's cool about your coaching is yours is niching down. I'm sure you could do business coaching in general, but you're niching down and focusing on the providers and the owners that you work with on customer service. That focus on customer service will translate into greater patient retention and referrals from family and friends. Tell us a little bit about that and maybe expound upon your focus a little bit if you can.

You nailed it on the head there. The focus is on customer service. From a chiropractic standpoint, my ultimate goal was to serve my patients and to help them get healthier. I know that's what physical therapists do too. They are there to serve their patients, help rehab and get them healthier. We can do that through our service and the mechanics of that. The problem is when our customer service doesn't align with our service attitude and trying to help our patients get healthier, I don't care how good a chiropractor you are, the best adjuster, and do phenomenal on that side, if the customer service is bad, if your staff treat your patients bad, they're going to leave you

I assume the same thing would happen with a physical therapist. My concern is let's quit having that happen. Let's improve the service side of things. I mentioned to you that my philosophy of coaching is doing these simple and easy action items. They seemed so stupid easy but they make a huge impact on the patient's perception of the service, being valued, feeling valued and important as they walk into a clinic. On top of that, you give great service through the mechanics of physical therapy and the rehab that you do. When you mesh those two together, that patient's like, “I love that office. I feel physically better.”

Psychologically, they’re like, “I love going in there because they make me feel like I'm the most important patient in the world.” Subconsciously, they're like, “I'm going to tell my friends. I'm going to tell my family. I'm going to get others to go in there so they will feel physically good. They're going to be treated like a rockstar when they walk in that office.” That's my purpose and my passion behind niching down to customer service to meld all that together, to help those businesses grow. I know we have good products from the side of physical therapy that's a great service and a needed service. Let's get that customer service in there to enhance it and grow these businesses so patients can get healthier.

I'll never forget. I had an interview with the founder of a software program called Keet Health. We were talking about marketing and what you can do for patient engagement, retention and whatnot. I'll never forget and it's hard to figure this out exactly, but he believed that we could triple our marketing efforts if we simply focused on customer service more. Provide a great service from the initial contact, that initial phone call all the way through collecting the balance down to $0. If we focused on customer service throughout the life cycle, we could triple our marketing efforts. That makes me think, “All that time I'm spending on marketing could be focused on customer service instead and get some of the same results if not better.”

There are a couple of stats that I like to use along those lines. One is it's 5 to 25 times more expensive to market to acquire new patients than it is to keep the current patient. There's a ton of money going out to external marketing, which is needed. The problem is you need to do something to the internal market to keep those patients. That's where the customer service comes in. The other stat that I love to use and this is from Harvard Business School. They did a study that a 5% increase in patient retention or customer retention through customer service can lead to 25% to 95% increase in profits. The reason that can happen is because as you’re increasing retention, you're keeping those customers and patients, they're referring more. You don't have to throw as much money into external marketing. That goes to your bottom line. That's what can increase that profit margin for you. I preach that all the time. I would completely agree, triple, quadruple and five times the profit, I can see that happening. I've worked with some clinics and it's pushing there.

We talked a little bit and it seems fairly similar between chiropractors and physical therapists in that, you get drop-offs like we do. They tend to occur somewhere in the 3 to 5 visit range where they haven't fully bought in and they lose the enthusiasm. They fizzle out and they're gone. If you can simply keep more of those people through their full plan of care to see the results, that might go straight down to the bottom line because your expenses don't necessarily increase, but keep those people involved, keep them engaged. What are some of those things that you talk about to help providers focus on customer service with their patients?

There are several things, although I want to touch on why physical therapists and certainly chiropractors lose patients after a couple of visits. This is outside of customer service that I've found that's common is they don't communicate the seriousness of a patient's condition correctly. We touched on that a little bit where they don't give them the overall picture that, “If you don't take care of this now and do it correctly, it may not bother you in a couple of months. Fast forward, 5, 10, 15 years down the road, this could become a major issue that could keep you from golfing or taking care of your grandkids or whatever the case may be.”

PTO 120 | Patient Retention And Referrals
Patient Retention And Referrals: You can save a ton of time and money if you swallow your pride and work with somebody that knows what they're doing to help you grow your business quicker.

The chiropractors and physical therapists tend to get too near-sighted and not communicate the longer-term effects. That's one thing outside that certainly will help. From a customer service standpoint, the patient comes in and from a chiropractic standpoint, they're hurting. They want some help. They need some relief and those types of things. Chiropractors are good with that, initially. If they do x-rays and be able to say, “Here's what's going on. Let's get you adjusted.” The patient is going to come in and get a little pain relief, but things aren’t communicated well and the ball has dropped as far as customer service. If they don't feel like they're valued or important like, “We're here to take care of you, get you out of pain and get you healthier. We're here to serve you first,” those patients are not going to stay very long. A couple of adjustments, they get a little relief and they're like, “I'm out of there. That office could care less if I'm there or not anyways.” They're gone.

You said it on our phone call that the patients will take their injury only as seriously as the provider does. If the provider comes up and says, “Figure it out with the front desk. Schedule one time a week, two times a week, maybe three times a week or whatever you can do. You guys figure it out and then we'll see you next time you come, and we'll do some good stuff for you.” It’s a laissez-faire, “I don’t care.” They're not saying “I don't care,” but the attitude comes across like, “I don't care. Just show up and we'll get you better.” You'll lose some confidence in that regard as a patient. The patient is sitting there thinking, “Do I have a problem? If you're not taking it seriously, then I guess it's not a big problem. Why am I spending my copay dollars on this one if it's not a big deal and you're taking it lightly?” I love what you said that they'll take it only as seriously as the providers do.

They'll default to that. I can tell a patient, “You're going to die tomorrow,” but if there's a disconnect, “This is what's going on,” and God forbid, I've never had that happen. I'm just using this as example. The seriousness of it, if I don't communicate that or even if I do communicate it and I have a disconnect, “Give us a call in a couple of weeks and we’ll see how you're doing.” That causes that confusion and they're like, “I'll see if I remember in a couple of weeks to let you know if I need to come back in.” If the doctor, the physical therapist, and the chiropractor don’t take it seriously, the patient certainly won't. You lost credibility and you lost patients following through on what they need to.

That goes even back to what we were talking about on some of the small things you can do. They’re at the front desk as they're having these interchanges, especially the first time they walked through the door. You can lose a lot of patients right there. No matter how good a provider you are, that front desk person has nothing to do with the physical therapy care that you provide. If they lose them there, it doesn't matter what care you provide. They're so valuable. Sometimes we put an ad out for someone that's $8, $10, $12 an hour and hope for the best and not focus on that. Whereas that could be a huge detriment to your business. The ones that are great are great and those clinics do well.

I used to tell my staff, but I tell my clients now, you could have the greatest chiropractor in the world, but if the staff is terrible, you're going to have maybe at best an average business and it probably won't even be that good. You could have an average chiropractor that's decent, but if you have a tremendous staff that does great with customer service, you're going to have a tremendous office. It's that valuable.

What are you telling some of these teams to do in order to focus on customer service? Are there exercises you take them through or are there tips and trainings that you recommend?

I train them on a lot of different factors. There are a lot of different pieces to great customer service. There are five that I focus on with most offices, clinics and clients because they provide the greatest bang for your buck. You could look at this and this and it had marginal gains. Through my research through my clinics or my clients, I've never been down to five pieces of the puzzle that if a clinic, a PT, a chiropractor will focus on these areas, it increases the perception of customer service in that clinic for the patients. That's what you want to do because customer and patient perception is everything. The patient is going to perceive customer service by how you make them feel.

If you're doing everything to make them feel valued, then you're going to have pretty good customer service for the patient. The five areas that I focused on, one is positive mental attitude, positive aspects of the office, and keeping that positive mind frame from the owner, the PT, the staff and all the way through. It's hard to provide great customer service if everybody's walking around that's ticked off with a negative attitude. You may say the right things, but the attitude comes through. It's not going to be as effective.

Doing simple and easy action items seem stupid, but they make a huge impact on the patient's perception of the service. Click To Tweet

Do you find that teams often take on the personality traits or the attitude of the leader, the owner, the main provider on the team?

They do and that’s why I want to train the owner, the PT, the chiropractor or whoever is at the top first. If I go down to work with the team members, I can get them all riled up and have them functioning at a certain level of customer service. If it's not at the top and working down, it's going to be undermined and it will not be as effective. They do take on that attitude from the top down. Whoever is on the top is, it's going to work its way down for good or bad.

You tend to see that especially in doctor's offices. You're like, “Not that the temperature is cold, but it feels cold in here with my interactions with the people.” I meet the doctor and I think, “That's why.” Sometimes you can get that front desk person who rises above it and has an attitude that no matter what the environment is around them, it can be of high excitement and high tone that you don't see a lot of that. They usually match the other people in the office.

If you do hire one with that great attitude, they start rolling it back down and match it too. We always want to start from the top and work down and make sure everybody's on the same page.

Number one is a positive mindset.

The second one is creating a team atmosphere for the whole employee interaction.

This isn't necessarily customer-related. This is more you and the team.

It’s you and the team, but it goes to the customer in the sense that you can't have great customer service if you're treating your employees bad. Happy employee equals happy patients. There's got to be that dynamic. I'll point fingers at myself. There are several years in my practice where I had this mentality that my office staff and my employees were a liability. My job is to nitpick every little wrong thing they were doing to correct that all the time. All that did was foster more wrongdoing, bitterness and irritation. It was very difficult to create a positive atmosphere and great customer service.

One of my coaches finally called me on it and said, “You need to quit doing that. You need to pick out and start focusing on the good they're doing, which is far more than the negative they’re doing.” Foster this team atmosphere that the front desk may not be doing anything as far as an adjustment or diagnosing, but they're helping the physiology of the patient when they walk in by treating them like they're important and like they're valued. Setting them at ease and calming them down, which helped me on the back end taking care of their physical health. I bought into that. Every employee, maybe some had office manager title or some were new and they were filing paperwork, but they all played a part in the success of the business. However big or little they may seem, but they all played a part in how successful the business was because of how they interact with the patient and make sure those patients felt like they were important.

PTO 120 | Patient Retention And Referrals
Patient Retention And Referrals: It doesn’t matter how good a chiropractor you are; if the customer service is bad, if your staff treat your patients badly, they're going to leave you.

Also, because they were happy. That’s number two. We've got a positive mindset and a team atmosphere.

The third thing is to create a friendly atmosphere and there are a lot of aspects to that. Customer service begins and ends with a friendly atmosphere. From the second that patient walks in, “It’s good to see you, Nathan. We're glad you're here. We're going to take care of you in a couple of minutes. Have a seat. If there's anything you need, let us know.” When you’re through the process of getting your treatment and then as you're leaving, “Nathan, we’re glad you came in. Let's get you scheduled for your next visit. You take care. If you need something, let us know. We appreciate you.” I call that bookending. Be overly friendly on the front side and be overly friendly on the backside. The patient leaves that perception like, “They love me here. This is great. I love coming into this office.”

My mission statement or my customer service mission statement in my clinics and this is what I teach my clients is to be the best part of the patient's day. You don't know what that patient's going through on a day-to-day basis. They're in pain. Their dog died. They're late for work. Their kid is sick. They're having trouble at work or whatever the case may be. There are a lot of problems in life. When they come into my office, I want them to be able to forget about those problems. I want them to feel like they are a rockstar, superstar, and the most important person in the universe when they walk into my office. Make it the best part of their day so when they leave, they're rippling that out to the people they interact with when they leave.

Sometimes we forget as providers, coming to physical therapy 2, 3 times a week for up to an hour at a time is a disruption to normal life. They sacrifice a lot. That sacred time for them, whether that’s taking away from work or taking away from family or even some spare time that they don't have a lot of. They sacrifice a lot to come often throughout the week and for weeks at a time to care for themselves. It's important for us to recognize that and thus provide a great atmosphere like you're talking about for them to be a part of. Otherwise, I can see where they fall out quickly if they're not getting recognized when they show up and as they leave. If it's not happy, if it's not fun or if it's not engaged, if no one asks them a whole lot on the way in or the way out, why bother sacrificing my time for that?

You feel like a number instead of a rockstar or a person, “It’s probably good. My shoulder feels a little bit better. I got to take care of other things.”

We all have that. There are plenty of other things we could be doing. That's number three.

Number four is being faster and more efficient as a business as a whole. There are a lot of aspects of that too. From a physical therapy type situation, the physical therapist has to spend a lot more time with their patients, 45 minutes to an hour. You can't expedite that necessarily. You got to have that quality time, but you could be faster with setting appointments, maybe having extended office hours, and make it more convenient for a patient to do business with you. Being faster at expediting when they're done with their session, they’re paying to leave, being faster and expediting new patients to get them in. Being faster with getting insurance inquiries back to them and returning phone calls. There's a whole lot of aspects there. We live in a microwave society. That's not going to change. We know we want everything then. We have to be conscious of that and do everything we can to make it quicker, more efficient, and less obstacles in the way for them to do business with us. That makes a huge difference.

There's something to be said for going to a place and they have my paperwork already for me versus, “You're here now. Let me print out the paperwork for a minute. Take a seat and I'll bring it.” You’re like, “No, I have it already for me.”

Customer and patient perception is everything. The patient is going to perceive customer service by how you make them feel. Click To Tweet

You walk in and you go, “Nathan, you're the new patient. It’s great to see you. Here's your paperwork. There are three pages here. Fill that out quickly. We're going to get you in and out of here as quickly as we possibly can.” That tells the patient that you have their best interests at heart. You are conscious of their time. Everybody's time is valuable. You're telling them, “We're glad you're here. We're conscious of your time. We're glad you chose us. This is how we're going to help you because we're going to be quicker in taking care of you.”

Looking ahead on the calendar and seeing, “So and so is coming,” and maybe not just the front desk, but even as providers. We say, “What do I want to do with this patient?” Maybe look in their past chart and say what happened in the past. To bring that up to them and say, “In the past, we did this with you, how did you respond?” Instead of them saying, “We tried that before” and maybe they won't even say it to you. They might say, “You guys are trying the same thing over and over again. You haven't even asked if it's working.” That's what you're talking about. It’s being prepared and looking forward. Treating each patient as someone who is infinitely valuable and treat them accordingly.

It's amazing what a difference it'll make in the patient's mind when you take those little steps to do that for them. Not treat them like a number and run them through because you're trying to meet a certain financial level for the month. It's okay to do that. First and foremost, it has to be on serving the patient.

What is the last step?

Number five is I call it fixing problems or service recovery. Every office drops the ball somehow some way. To be able to recover from that in a specific manner makes a huge impression in the patient's mind. A consumer that had a problem and the business took care of that problem in an efficient manner to their satisfaction, they have more loyalty to that business than the consumer or the patient that didn't have any problem at all that but they didn’t experience great service. It'll add to that extra level of loyalty that those patients or the consumers will have because of the problem and the way it was handled.

The nice thing about customer service, when you have great customer service, you're going to have less problems. You don't have as many to take care of. Even if it's glaringly the patient's fault, you still have to treat it like your problem because it is your problem. If you take care of it right, you create that extra value with that patient or that customer, and they become your strongest advocate. I saw that many times in my career. In my chiropractic office, those patients that we took care of those issues, they were phenomenal. They were referral machines after we went above and beyond what they thought we should. It's a great thing. Now, you shouldn't try to create problems to create that extra value. That's not the point here. The point is to have a system to take care of those problems efficiently and do it in a great manner. It benefits you tremendously.

To that point, are there some tips that you recommend people use if a patient is upset or comes in with a concern, how they address it appropriately, any advice you can share?

Three main things, one is to address it immediately. We talked about being fast and doing things in an efficient manner. You want to address the problem immediately in the sense that, “I'm sorry, there's a problem.” Go to resolve it as quickly as possible. The other thing is to apologize immediately too. If it's the clinic's fault, if it's an employee's fault, you're going to apologize. You want to do that and take responsibility for it. I also coach and recommend that you apologize, even if it's the patient's fault. You apologize in the sense that you'll say, “I am sorry, you're going through this. I'm sorry, this is happening. Let's make this right for you.” You're not necessarily taking the blame for it, but you're still putting that patient that customer at ease by saying, “We recognize it’s a problem. We're sorry you’re going through this. We're going to take care of it.” Those two things are huge.

The other thing is don't play the blame game. If it's the patient's fault, you shouldn't have done that. Don't play that because all you're doing is creating anger. You're fueling the fire. Nobody's going to win, it’s what will happens. The patient's going to be upset. They're going to leave. You're going to lose a valuable patient, possible referral source, and profits coming into your office and your clinic. You got to be careful there. Apologize, do things immediately, and do not play the blame game.

PTO 120 | Patient Retention And Referrals
Patient Retention And Referrals: You could have an average chiropractor that's decent, but if you have a tremendous staff that does great with customer service, you're going to have a tremendous office.

We want to do that. We want to find out who's to blame for this so that we can point the right finger at the right person. It's so much easier when you say, “No blame, no pointing fingers. We're in this situation, how do we simply resolve it?” It allows the emotions to stay out of it. That's for sure.

That's the main thing. You want to keep the emotion out of it. When emotion gets high, reason gets low and that's where everything blows up. Be very conscious of that.

Any other little tips along the way that you share with people? Wear your hat the right way or sit the right way, anything like that that you can tell people. These little things if you think about them, they can improve customer service.

There are two things that are so stupidly easy that whenever I tell people this, they're like, “We already do that. That sounds good, but it can't be that effective,” but it is. My coaching philosophy is doing the simple things consistently, that's where you're going to get major results. These two things that I want to share are very simple. The first thing is to put a smile on your face. Every employee, every day, the practitioner, everybody has a smile. What I tell my clients is a smile should be part of the uniform of every employee. If they wear scrubs or if they put a name tag on, a smile goes along with that. Smiling is the universal welcome. It immediately puts people at ease when they see a smiling face. It calms them down and it lets them know, “We're here for you.” Smiling seems so ridiculous, but it's not. It's very effective.

The other thing is I call it manners matter, but it's using three phrases, please, thank you, and you're welcome. Everybody goes, “We know that.” They may know that, but in this day and age, it's lost a lot. I recommend using those three phrases in every form of communication too, face to face, on the phone, text, and email because those are a big part of most clinics' communication sources too. They show respect for the other individual.

I like that you also included emails and texts in that because think about confirmation calls. I don't recall a lot of please and thank yous. I'm glad you included that.

It takes the edge off. It's showing a little bit of respect to that person. You're trying to drive perception. If I'm sending a text, “I want to verify your appointments. We appreciate you. Thanks for being a patient,” or something like that. How easy is that? If it's an automated text, it’s like, “They're glad I'm a patient.” Those three phrases are so simple to use. It's so simple not to use it as well. That added an extra edge of, “I appreciate you, your valuable to me, your valuable to this office. You're important to this office. We're going to respect you with that language, to verify and to show you that's what we mean.”

This sparked a thought in my head. You talked about you bring these things up to them like you should be doing these things, smiling, please, thank you, you're welcome. People will say, “We do that.” Have you ever used any secret shopper exercise or anything like that? Maybe you call the front desk to see what words they're using, what verbiage they have, and what tone it is? Have you done that before? I'd assume most of the time the owners are surprised of what they hear.

Happy employees equal happy patients. Click To Tweet

They are. Nine times out of ten, it's not as good as they think it is. That's the funny thing about customer service as a whole. Most businesses think they provide great customer service and they have certain aspects of good customer service. Maybe they do a little of this and a little this. As a whole, the perception of the patient or the customer is they don't have that great customer service. What a lot of businesses do and this is very common and I did it as well, is you'll have a new patient come in, you treat them once or twice. That's the honeymoon phase. Everything is all hunky-dory and roses.

You send them a, “Do a quick Google review for us.” They'll give you five stars every time. Give it another 2, 3, 4 or 5 weeks and see if that patient is still in your office for one thing. If they are, let's see how they're going to review the office at that point. Is this still going to be a five-star? To me, that's not a legitimate Google review, if it's the first couple of visits. As I was saying about chiropractors, the first couple of years in practice, they don't know enough to know what they don't know. It’s same with patient's first impressions, "They treated me pretty good. I'll give them a five-star review. I don't want to say anything bad about them.” Once they get a little bit of understanding, most of the time, it's not quite as good as what they'd like it to be.

The newness fades a little bit. Maybe it's not a five-star review anymore. Maybe it's closer to 4, 3.5. I noticed these things over and over again that you guys don't do.

It’s probably the first couple of times, but it keeps happening over and over.

In that regard, do you also recommend doing surveys with the patients’ NPS, Net Promoter Scores and that kind of stuff?

There are three metrics that I promote with my clients. You want to get a patient score survey and understand where they are. What I recommend is a 1 to 10, if a patient says 8 or below, then you need to contact them and see what is going on. Why are we an 8 or lower? What's our problem? What do you see as an issue? How can we improve? The second survey is an employee survey. Question them, would you recommend your friend coming to work here at this clinic, this office, this location?

You need to do this in a way where it's not going to be if they say no, that it's going to be a problem. You understand why they wouldn't because happy employees equate to happy customers. If the employees aren't happy, customers are not going to be happy. It's going to cause a problem and disconnect. You got to be careful with that. The third metric is profit and cashflow. There are a lot of KPIs that you can work through. These three came from Jack Welch, the CEO of GE. Those are the metrics he used. If they’re good enough for him, they're good enough for me.

If he can do amazing things with GE back in the day, then I can do the same thing for my clinic. They're great. The patient survey one is obvious, but I love the employee survey. When it comes to the cashflow and bottom line, that's the bottom line if people are liking you or not.

PTO 120 | Patient Retention And Referrals
Patient Retention And Referrals: It's hard to provide great customer service if everybody's walking around that's ticked off with a negative attitude.

The purpose of the business is to get a patient or get a customer. You need to keep that customer and then make a profit. A lot of businesses, they understand to get a customer. They do very little to keep the customer and then they try to make a profit, which to some degree they can, but they are missing the whole aspect in the middle of keep that customer, which expands the profits. That should be the focus. My passion is to help businesses do a better job with that.

Thanks so much for sharing your time. Is there anything else you want to add before we sign off?

No, we've covered a great deal. I appreciate your leading questions and help me to open up some of this stuff. I've loved our conversation.

You've provided a ton of value. If people wanted to reach out to you individually, how do they do that?

There are several different ways. You can go to my website, By all means, email me at If you have any questions would like to contact me and maybe set up a chat, I'd love to do that. If you like to text or call me by all means, I'm open to having patients or potential leads and clients call me. My cell phone number is (575) 706-3304. I'd be more than happy to talk about what we do. My coaching is a little different. I call myself a multiplier and my goal is to help multiply getting patients. If it's PTs or chiropractors or customers, multiply profits, growth, employee engagement and multiply all these things that we've talked about.

We do that from the inside out. We look at the internal things and change the dynamic. It’s not to change the business completely. Let's just enhance certain things that are going to create the greatest results. The 80/20 rule, let's look at this 20% set of things that are going to give you 80% of the results and see what happens. That's my coaching philosophy. My coaching programs are customizable. I have different time periods, 3, 6, 9 months, depending on if some would like to spend more time with me, weekly calls or monthly calls or biweekly, whatever the case may be. There are some customizable pieces to my coaching to make it affordable to the different price points and different budgets of the clients I work with.

Hopefully, some people reach out and get some more information from you, but thanks for all the information that you provided. It was a great help for many owners.

I appreciate the time. Thanks so much, Nathan. I enjoyed it.

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About Kelly Henry

PTO 120 | Patient Retention And ReferralsFor 20+ years, award winning chiropractor Dr. Kelly Henry helped patients achieve and live healthier lives.

With the foundation of exceptional customer service and streamlined business procedures, Dr. Henry grew his business into the top producing chiropractic clinics in the nation with multiple locations and doctors.

After retiring from private practice in 2018, Dr. Henry has dedicated himself to consulting and coaching business owners on how to create incredible growth and profits using the processes and procedures he used to create phenomenal success in his offices.

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PTO 87 | Leaders In Your Company


As your business grows, it is important that you learn to entrust it to others as well. That is why, for this episode's returning guest, the job of a leader is to develop other leaders. CEO of Performance PT and FitnessStephen Rapposelli, PT, is back to bring tremendous value about developing a leadership team. Having written an article in Impact magazine about the qualities to look for in potential leadership, Stephen shares those with us and discusses how we can structure our own leadership development programs to assess, test, and develop our own leadership teams. This episode is very valuable for anyone looking to continue to grow their businesses because, at some point, you become the stumbling block to your progress.


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Cultivating Leaders In Your Company With Stephen Rapposelli, PT

I've got a returning guest, Stephen Rapposelli out of Delaware, who on a prior episode, discussed an Impact Magazine article which he wrote regarding creating values for your company and how to go about doing that. It's one that I've recommended to coaching clients and friends a number of times in the past. I highly recommend you go back and check that. He also turned the tables and interviewed me about my professional path. If you're interested in my history, you can go ahead and look at that. I brought him on again because I saw that he wrote another Impact Magazine article about developing leadership teams, most notably qualities to look for.

We also delve into how to develop your leadership team, find those best candidates and what to do once you find them, how to train them and how to coach them going forward. They can take the burden off you eventually and continue to grow and expand your practice, and maybe make up for some of the flaws that you have as an owner. As always, Stephen shares a lot of wisdom and even asks me some of the things that we did to develop our leadership team. We go back and forth, sharing some experience on how we develop our leadership teams to move forward.


I've got a returning guest Stephen Rapposelli, Physical Therapist, CEO of Performance PT and Fitness in Delaware. He is also the VP of the Delaware PT Association. First of all, I’d like to welcome you, Stephen.

Thank you, Nathan. It's always a pleasure to be with you.

Thanks for coming back. I appreciated and I've referred plenty of people, including coaching clients back to our previous episode where we discussed values and how to establish those and it's still vitally important. I recommend everyone to start with purpose and values as they're developing a structure to the business model. Thanks for sharing and being such a valuable part of history.

It's always fun to talk about values. On the surface, that sounds boring, but it helps guide every decision you make as an owner.

The reason I'm bringing you on is because you had an article in the Impact Magazine about developing leaders. Foundationally, we can say that before we even consider leaders in our company, we have to go back and establish the purpose and values of our company. Otherwise, how are we going to determine who's in alignment with us to become those leaders in the future? How are we going to base what kind of leaders we want and what is expected out of them if we don't have those things, to begin with?

Your job as a leader is to create other leaders. Click To Tweet

Your values are your ultimate filter for everything.

It starts with hiring but your leadership team who eventually will be your leaders of your team should be the people that are completely bought in. They live and breathe the values as you do. They are making their business decisions on your behalf or on the company's behalf according to those values like you.

If you manage by gut reaction, think about it, and spend the time to think it through, that gut reaction is an identifiable, quantifiable series of filters which are your values.

A lot of times it's based on those initial gut feelings that help us determine those values, to begin with. We eventually put words to them and we do quantify and qualify them but it's that gut feeling of, “That explains us,” or “That feels right.” That's how we know when we have the right ones and when people are in alignment with us.

All of us who think we're good clinicians, we feel that we have this special magic of why we're good. Nathan had his magic. Steve has his magic. That “magic” is something that can be identified and more importantly, it can be taught. As an owner, you should be constantly thinking of how you can transfer whatever magic you have to your staff in order to elevate them.

It's vital to transfer that same knowledge in order to grow because we can't expect everything to be on us. If we do so, we're going to be burning the candle at both ends. We don't have the energy for that and we will be the limiting factor in the growth of our company if we don't write down and set that purpose and values, and hire and fire accordingly. Other leaders can step up, develop and continue to the growth of the company.

The number one job of a leader is to make other leaders. That's it.

On the surface, talking about values sounds boring, but it helps guide every decision you make as an owner. Click To Tweet

You listed a number of things in the article about qualities that we can look for and this goes beyond values. We hire and fire accordingly. There are some people that you might consider as leaders but are simply good therapists. They have the values but maybe good at leading other people. They share the values, but they may not have that skillset. Besides that, what are some of the things that you've listed out that you think are important to acknowledge and people who could be potentially good leaders?

There's a number of them. You bring up a good point, which is, “The best leaders aren't necessarily the smartest people in the room. The best leaders of your business aren't necessarily the best physical therapists.” Those are different skillsets. They both need to be identified and groomed by you so those people are behaving up to their fullest potential. The first thing that I talk about is intellectual humility. You are never done learning. You look for people who are insatiably curious. Insatiable curiosity are those people who are asking questions and always wanting to know how something works, “I wonder what would happen if this or that.” Those are the people who are going to be constantly growing. They're going to be lifelong learners and that's one of the characteristics that not only you should have, but you should also be looking at others.

You can't expect two people to naturally know how to lead and to naturally run a business because that's essentially what you're wanting them to do. You're wanting them to run at least a portion of your business. That's something that if they've been through physical therapy school, they haven't had any business training. You would expect them to be wanting and willing to learn more. Either through working with the same coach or consultant that you work with or reading some of the same books that got you to the point where you are so they're in alignment with some of your thought processes. They need to have some of that same intellectual growth.

The thing that I look for is the people who are raising their hands. Who are the people volunteering and saying, “I'd like some help and direction. Show me this. Tell me how to do this. I'm looking for this?” There has to be that innate sense of volunteerism that demonstrates to me that they are going to be the ones that go and get it. It can be something simple. We have a road cleanup a couple of times a year where we go out to a local road and clean the trash up. Who are the people that show up? Sometimes, you need to tell people, “This demonstrates to me that you want to do a little bit above and beyond. Therefore, I'm going to give you more to go above and beyond. We're going to be limited by whatever your ability to grow is going to be.” A lot of people in this day and age don't understand those behavior traits that the leaders look for future leaders. We need to tell them. We can't assume that they know that that's what you're looking for.

It's the leader’s responsibility to develop other leaders and part of that is coaching your team. You're going to have one-on-one conversations with them. Either they express a desire to grow in a leadership path or you've talked to them about, “You might have the desire or the capabilities to do so.” You start having one-on-one conversations. It's imperative to say, “This is what a leader looks like. This is what I would expect.”

We all make assumptions that we shouldn't be about what people already know, what you think maybe basic or even intermediate level thinking. You can't be that way. You have to express it and communicate it. A key to that starts with being vulnerable and being authentic to your staff because that's how you develop trust. If they don't have trust because you haven't been authentic and vulnerable in your leadership path, they're not going to meet you halfway.

I learned that when we had our two-day Annual Leadership Conference. We spent a good part of the day trying to be vulnerable and authentic with each other because we felt that there was a certain level of trust that was missing among our leadership team. It was exhausting and it was hard. People were visibly stressed but then we had a breakthrough. I'm not saying that every interaction with your staff has to be an intervention. You do have to be able to allow yourself to be seen as a fallible human being that is trying to do the best that they can. A lot of times, leadership starts with yourself and how you are leading yourself. You become either an example to others or a warning to others based on your behavior and what people can see that you do.

PTO 87 | Leaders In Your Company
Leaders In Your Company: As an owner, you should be constantly thinking of how you can transfer whatever magic you have to your staff in order to elevate them.

That's a huge quality that you need to look for in your leadership as well. You talked about the ability to be vulnerable, not have to be right or correct in every circumstance, be willing to recognize when you've done something wrong, and ask for questions. It might expose you to someone who doesn’t know you. You talked about insatiable curiosity. That touches into that a little bit, but there are some people that get a feel. The gut reaction has to be right or they have to be seen as better than so you have to be wary of those people. Help them to understand that being vulnerable and being fallible is okay.

The bottom line with all of this is a lot of these behaviors that we see are a result of fear. It's a fear-based mindset and you have to recognize it, appreciate it, move people from that and look for other people who have that ability and that capacity. Those are the leaders of your business.

Considering you went through this exercise, did you follow any particular book or program to get you guys through that stage to expose yourselves, become vulnerable and increase the trust of your leader as well?

As it may have been said in other places that leaders are readers. My ability as a leader is directly proportional to the amount of time that I spend reading. With that said, there's a whole list of great books out there but I'll break it down to 2 or 3 books that are almost required reading for anybody on our leadership team. Some of these, you might outgrow a little bit and you might be like, “That's an old one.” I'm going to go on a tangent here. A lot of the things that we hear is a rehash of ancient wisdom that goes back a long time. The more you're in the space of leadership and the more that you read, the more you say, “I heard this before. This was somewhere else.” I'm a big fan of going sometimes 4,000 years back. Let me give you some examples.

Number one, The 7 Habits of Highly Effective People by Stephen Covey. That's the one that everybody should probably read once a year. The way not to read is to read a book once and then put it up on your shelf. You have to take that thing out, you’ve got to dog-ear and underline and you’ve got to use no cards. You’ve got to talk to somebody about any tactic you can think of to squeeze as much juice out of that book as you can. Number two, How to Win Friends & Influence People by Dale Carnegie. I read that book when I was fifteen years old. I don't know what possessed me to read that book. It was truly dumb luck and his lessons are basic but they're not done by 90% of the people. You can be exceptional. It's easy to be exceptional by following some of the things that Dale Carnegie speaks of. For example, looking people in the eye, calling people by their name, and shaking people's hands. People like to scoff at that but how many times do you go down to your local department store and nobody even looks at you or talks to you? Getting these basics down is fundamental in being a leader.

Next is Executive Toughness by Jason Selk. That is an outstanding book. I finished it twice and I'm going to be implementing it like that. Emotional Intelligence 2.0, you've heard that one before and that's a good one. Here's one that you probably haven't heard of The Art of Living by Epictetus. Epictetus was a stoic. He lived about 4,000 years ago. It is a short book and it is basically one lesson a page. It is life-changing to read that book. One of the things that Epictetus says is, “Don't take things personally.” That'll change your life when you come to the realization that not everything that comes into your world is about you. I like to think that you need to get to be about the age of 40 before you finally realize that to be true, but some people get it earlier. You get to a point and read the book, The Art of Living by Epictetus. Those are some of my required readings for leaders. The list can go on and on but the older wisdom and truce are the ones that have lasted the test of time.

I want to reiterate that this is expected reading for your leadership team. At least some of these if not all. We had the same thing. If they were a leader, they were going to be expected to read some of the same books that we thought were important. Whether it's The E-myth Revisited, Good to Great or Leadership and Self-deception and The Five Dysfunctions of a Team. I thought you were going to go with Five Dysfunctions of a Team by Lencioni in terms of developing this meeting that you have.

Your values are your ultimate filter for everything. Click To Tweet

As he says, the first level that you have is to have as an effective team is trust and ability to be vulnerable so you can get a commitment, buy-in, and conflict. That's a huge book. The first time I read it, I was like, “Okay.” Sometimes, you have to read things over and over for it to stick. Maybe it's my own simple mind but you have to keep revisiting these things. The other thing to recall is when you try any new skill, you're going to be lousy. We operate by Gino Wickman's book Traction and the first year and a half, we were lousy. We weren't hitting any of our rocks, our rocks were poorly defined, and issues were all over the place. Anything you do, you have to stick with it. You do get better with time.

I have a couple of coaching clients that are voracious readers. They've read them all. They're at a point where I'm like, “You need to focus on one. I know that you know the concepts. You need to start drilling a mile deep and an inch wide instead of an inch deep and a mile wide.” Take any of the concepts that ring true to you and start implementing them. Dedicate yourself to one thing. It's interesting that you talked about focusing on Traction by Gino Wickman because there are plenty of people that have read it but haven't implemented what he’s recommended.

There's a huge difference between planning and executing. As Mike Tyson famously says, “Everybody's got a plan until they get punched in the mouth.” He’s a great philosopher.

You have a bunch of books that you have your leadership team read. Are there any other qualities that you're looking for as people who could potentially be leaders on your team as well?

There are stages to an employee's life. The first stage of an employee is they don't know what to do. The first stage is, “What do I do?” The next stage is, “What do I do next?” The next stage moving up the ladder is, “Is it okay if I do this?” The fourth stage, which you're trying to get me to go to is, “I did this and then this happened. Now, I'm going to do this.” What you look for are people that have some initiative, willing to try things out and see what happens. I don't know how else you coach that other than giving them the opportunity to know that they're safe if they fail and there are few things that are going to be fatal in a physical therapy office. There are some things that could be, but by and large, there are few mistakes in this world that can't be understated if I can use bad English. You encourage that, give them room and latitude and make sure that they're safe in doing it. You see where it takes them and it might be something simple and it might be something big.

The area where most leaders have to remind themselves is the WAIT philosophy, which is, “Why Am I Talking?” When you are about to talk, say the word WAIT and think to yourself, “Why am I talking?” As the owner, oftentimes you say, “I know it all. I have done it all. Let's get this done. Let's move on to the next thing.” You're stunting the growth of your future leaders if you don't give them the opportunity to stumble, fumble, be inefficient, awkward and to try to find their way. I find that personally difficult to do. I literally had to write it down in front of me before a meeting to keep reminding myself, “Wait, stop talking.”

That's an effective coach to someone who lets the other person verbalize, process and come up with the solutions. To say it another way, “We're looking for people who are willing to generate solutions to the problem without you being the answer.” To give you an example, we would give some of our potential leader’s homework assignments like, “What's a problem that they see in the clinic?” Maybe there's an issue with the laundry. They're not happy with how the laundry is getting done at a particular time in an efficient manner. Pick anything and come to me with the problem like, “Check it out,” and let them find a solution for it. We'll discuss how we're going to implement it and then have them oversee that process that they recommended. It’s something simple like you said.

It changes your life when you come to the realization that not everything that comes into your world is about you. Click To Tweet

Did you find when you were in practice that as you were evolving that you had to fight against not knowing what the front line problems were in your practice? Did you feel you knew every problem and every issue?

No. I was open to saying that I don't have all the answers and I know there are plenty of issues.

Do you encourage your employees to come up with those issues and then think of a solution based on what they felt the problem was?

As I grew over time as a leader, they would come to me with problems. This patient will say such and such and instead of giving them the answer, I started saying, “What would you do?” I let them voice their opinion on what they would do and if that was okay with me, go ahead and try it. I’m like, “Are you sure you're okay with that?”

You said something golden there, which is, “What would you do?”

A lot of them have the answers but they think that this is your clinic and this is how you would want things done. You have to get over that at some point and say, “No, this is our company. You need to own your position like I need to own my position. You need to be the CEO of your own role and recognize that you can affect things for the positive. There's a lot of latitude underneath my umbrella to perform and I'll check you if you go too far.” We would give them homework assignments like, “Find a solution for a problem that you might see in the company.” We get to task them with leading out on the team meetings so that we didn't have to be the people who’d establish the topics of the agenda and all that stuff. We let them do that and let them lead out. The peers appreciate seeing that from their leadership and letting someone else step forward and lead the team instead of the leader sharing his wisdom from the top of the mountain.

Was there a difference in your business between staff meetings and leadership meetings? Were those two different mutually exclusive groups?

PTO 87 | Leaders In Your Company
Leaders In Your Company: A lot of times, leadership starts with yourself and how you are leading yourself. You become either an example to others or a warning based on your behavior and what people can see that you do.

There were team meetings at the different clinics on a weekly level where the clinic directors were responsible for getting everybody together, discussing topics at hand calendaring, and sharing statistics. The leadership team was a different 3, 4 or 5 people that would discuss what’s going on between all clinics.

When someone moved up from the staff meeting level to the leadership meeting level, was it eye-opening for those people in your business?

Yes, especially when we shared financials then they could see that there's a lot going on behind the curtains at that point.

Did you see a change in their behavior once they were able to be a part of and witness the leadership level meetings?

Yes, for sure.

How can you let everybody get a taste of that? That's a challenge.

The best you can do is to give as much authority as you can to the people that are closest to the situation. That gets down to the clinic director level at least so that they can have immediate oversight of what's going on within each clinic since I can't personally be there. We're talking about a situation where there are multiple clinics and multiple physical locations.

All good things come to you with the price of an effort. Click To Tweet

It's a moving target because I know that in the past, I've shared an abundance of data with the entire staff and the feedback was, “Why are you telling us this? Do you think we're falling asleep?” You're like, “I overshot that one.”

We would have quarterly “town halls” according to Scaling Up by Verne Harnish with everybody. In those situations, we were talking from more global perspectives. Their favorite part, honestly, was talking about the values amongst the team, in which people within the team had exemplified those values in the past quarter. We'd share larger perspective items like the organization chart of the entire company and what their responsibilities were within the chart or discussing what charity or what value we're going to focus on in that quarter. We'd look at bigger picture things. We'd share some higher-level statistics here and there, especially if we met some great goals and whatnot. We didn't get down to the nitty-gritty, which is too much as far as statistics.

One of the top parts of our meetings is when we give each other what we call attaboys. It doesn't come from the leadership team but you let the staff members stand up and give each other praise for something that they were observed dealing that adheres to our values. Once you get that started, it becomes like a ball of fire and that raises everybody's ship. James Clear in his book Atomic Habits says, “Praise others. It will bring them peace of mind. Do not expect others to praise you. It will bring you peace of mind.” You look for that leadership trait in others and that is, “Be quick to praise others to lift them up but don't do it to expect praise yourself because you don't need it.”

Our team meetings were most successful when they were able to recognize each other and how they exemplified values in the past. It can become emotional, tears, excitement and almost without fail. That was the favorite part of their meetings. In developing that, that's where you start honing the values of your company and you also start getting buy-in from your company as we start going through these processes. Of course, you're looking for the initial qualities whether that's curiosity, first to share, first to raise them or volunteer. Every person should be able to sketch a leadership progression and it's typically tied to how you grew as a leader and what those steps might take.

It's the books we read, sharing some of the wisdom we received from coaches and consultants, maybe give them a little bit of homework that a leader would do, and start sharing some of the statistics that you were looking at on a regular basis. Also, maybe delegating some of the responsibilities over to them, especially if you're going on vacation for a week, “You're in charge. This is what I do and I expect you to do the same. See your patience because that's what I had.”

The goal of the owner is that the people that are under you don't have as long of a learning curve as you had. You want to try to eliminate as many of those mistakes. It is shocking. I tell people that I was successful in spite of myself. I was ignorant of everything and it took so long. You want to try if you can shorten that for everybody else because they'll make their own share of mistakes eventually. If you can save them some of the pain that we all have to endure as we move from novice to expert, that's a valuable and admirable goal as a leader.

That's your goal. When you consider a leader being powerful, how can you get the same effect in a shorter amount of time? If you can generate that type of power from a leadership development perspective, the power that comes with your leadership team and the opportunity for growth and acceleration, then it increases for that.

The best leaders aren't necessarily the smartest people in the room. Click To Tweet

You'll agree with me. It is so much fun to watch others grow into that role, make it their own and take it to the next level. It's fun.

I had an employee and her name is Stacy Sullivan. She tragically passed away but she stayed with me for probably 15 or 16 years. She was one of the first employees that I hired. She was a PTA. She left for a period of time to work somewhere else and then came back. I brought her on with open arms because she was amazing. Without me knowing, it had bought into the values. I don't know what it was but she was all-in on whatever I did and every mistake I made. We worked through and we talked through. I asked her a couple of times, “Why are you so loyal? Why do you care so much?” It's almost like she cared more about my company than I did and I couldn't understand it.

She did it and people liked that out there that will carry the banner for your company when they know that they're in alignment with you. You've probably recognized this yourself with some of your leadership team members. They're willing to go above and beyond and they hurt when the company is hurting. They're staying up late at night when the company is facing problems like you do. They'll own their position and that company will take on part of their lives.

Face it, Nathan, it's easy to get discouraged. There are many times where you say, “Am I the only one here? No one helped me plant the wheat.” You also have to remember that there are six billion people on this planet and they don't all have to agree with me. I need 10, 15, 20 or whatever your number is, of people that share those values and that's when the magic happens. Those people magically start to develop and flourish before your eyes. You have to water the plants. That's all you have to do. These are some of the things that you look forward to making sure that you're finding the right plan to work.

That's fun when you can start developing some of those people and see them grow in a capacity that maybe they didn't see for themselves. Going back to Stacy, one time, one of our coaches showed her the org chart and said, “Where would you want to go on this?” She said, “Don't tease me like that. I want to be over here. I want to be the vice president of marketing.” She's like, “Why don't we set up a path for you?” She was almost in tears. She couldn't have imagined as a PTA that she could become an executive within a PT company. She wasn't the greatest therapist. She had such amazing kindness and exuberance of personality and light that she brought to the clinic. She became one of our better clinical directors when she was given that mantle. She was a great marketer. She did want to build relationships across the town for us and she had that path. There are those people out there that will grow with you. The fun part is to see them grow.

Nathan, that story leads to my final tip, which is, “Leaders ask.” You never would have known that about her if you did not ask. You couldn't assume that she wanted to be VP of marketing or whatever position she aspired to be. Somebody had the wisdom to ask and it is amazing what you discover when you simply ask. The converse of that is, “How many mistakes do you make when you assume that you know?” That gets me every time.

When you ask, you show that you care. That's easy for them to buy in when they know that somebody cares about their growth.

PTO 87 | Leaders In Your Company
Leaders In Your Company: You're stunting the growth of your future leaders if you don't give them the opportunity to stumble, fumble, be inefficient, awkward and to try to find their way.

That comes from getting to know your staff personally. You have to take the time and the effort to get to know them. I'm talking about easy things like, “What did you do this weekend? Where did you take your kids? What's going on with your parents?” When you ask those questions, over time, you find out those answers then you have that connection with that person. You understand that person and then that can change everything about the whole relationship. It's my truth bomb.

You dropped it well. It goes back to you have to take the time and you can't be doing that if you're treating it full-time.

All good things come to you with the price of an effort. You're constantly thinking to yourself, “Where can I best apply my limited resources of time and energy to move the ball forward for everybody's good?” That's what you wind up doing. It was in another show and maybe yours where the girl from Alaska said, “I was getting to the point where I was treating patients and I was distracted by it. I couldn't focus on the patient. I knew I had to get out of patient care because I was thinking of other things.” That was golden to hear that because people say, “How come you're not treating patients anymore?” “I only have many things I can do in a day and my number one function that cannot be delegated is I’ve got to ensure that this business keeps its doors open because people pay their mortgages because of me.” That's a pretty big responsibility. You have to guard your energy well. That's why I love your show. I learn all kinds of stuff.

Thanks for joining me, Stephen. When I saw your article in Impact Magazine, I got excited and I'm like, “I know Steve will come on.” Not only because of your willingness to come on, but the topic was great. I know you share a ton of great information.

We're all in this together and we're all stumbling and fumbling our way through. None of us are experts. We're all learning as we go along. I have found at this point in my life that the more I share, the more I get back. Thank you.

If people wanted to contact you, are you open to that?

You can reach out to me but I'm not going to sell you anything. I will probably refer you anyway. You can reach me at my email address at or look me up on the internet.

Thanks. I appreciate it.

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About Stephen Rapposelli

PTO 87 | Leaders In Your CompanyStephen opened his private practice in Delaware in 1992, at the tender age of 26, because he was told by his former employer that he couldn’t afford to buy into that existing business. He has since grown to 3 clinics, and has been voted best PT business in his state for numerous years. He also serves as Vice President of the Delaware PT Association, as well as sitting on the IMPACT editorial board. Stephen plans on devoting the rest of his career to promoting independent practices across the country.

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