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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PTO 28 | Leadership Team


You can't do it all, and you won't achieve your business goals if you try do it all yourself. If so, your personal limitations become your business' limitations. You've got to develop leaders if you want to grow. How do you do it? Judy Cirullo, PT, ACC, CPC, ELI-MP has spent decades in physical therapy - as a therapist, owner, and now coach/consultant. Her professional experience has taught her many things, but one of the more crucial things she has learned and now teaches is that true freedom and stability for the business and business owner is achieved when they have a unified leadership team. It's one thing to simply have a team, but to have a team that is unified in purpose, mission, and vision is an unstoppable force. Judy trains teams across the country and now shares some of her secrets with us.


Listen to the podcast here:

4 Words For Clinic Success And Freedom: Develop Your Leadership Team with Judy Cirullo

PTO 28 | Leadership Team
The Five Dysfunctions of a Team: A Leadership Fable

I've got Judy Cirullo, a physical therapist who has been a very successful physical therapist over the past 40 years. She has owned and operated four private practices with one satellite, one fitness business in four different states. When I say that, she has opened and sold multiple businesses in multiple states over the past 40 years, so she knows what she's talking about when it comes to getting a clinic off the ground, selling it and moving on. She's also the Cofounder of the Aquatic section of the APTA and has written multiple books, articles, and chapters. However in 2015, Judy decided to enhance her partnership of helping other people reach their potential by focusing on business owners and teams. Her passion shifted from helping patients to helping business owners and their teams and transforming those teams into profoundly unified teams who are passionate about their purpose and their unified mission and vision. Her focus is not just teams, but also developing owners into masterful and efficient leaders with teams that support them and are productive and propel the business forward. She currently coaches one-on-one private coaching. She does leadership team development coaching. She does team trainings in line with Patrick Lencioni's book, The Five Dysfunctions of a Team. She is a public speaker.



We have Judy Cirullo, a physical therapist, who has been a successful physical therapist and a physical therapy clinic owner. She has trained and is professionally working as a coach and consultant for business owners across the board especially with physical therapy practices. I'm excited to bring her on because we're talking quite a bit about developing your leadership team. Judy, thanks for coming on.

Thank you for having me.

It's great to talk to you. Can you share with us a little bit about your story, Judy? How did you get into physical therapy? How did you become a clinic owner and what got you to where you are now?

Physical therapy was always my passion. I was bound and determined to go to school to be a physical therapist, so I did. It was a passion for me clinically for 40 years. It still is. After about two years in a hospital setting, I decided I needed more. I opened up my first practice in California in '92. Five years later, I sold that one as we moved to North Carolina. My husband's medical training took us all around, which was fine. I had a second practice in North Carolina. I also had a fitness business. They were side by side.

What kind of fitness?

It was exercise based. The clinic ran three days a week and the fitness business ran three days a week. I had someone else who worked with me on that. Those were all Calf based at that time. From there, we went up to Philadelphia and I opened a practice up there at the same time while I was developing and found the Aquatic section of the APTA.

I saw that. Thank you so much for your leadership on that.

The foundation for a successful leadership team is trust. Trust with the owner and trust with the other members of the team. Click To Tweet

It was a need for us because it's a component of what we do. It needed to be integrated into our professional standards. That happened at the same time, so I had an integrated Aquatic land-based practice there. I merged with another practice when it was time to move again. We moved back to the West Coast. We moved to Oregon and that's where my fourth and final practice was for almost twenty years. I sold that one. At the same time, I was getting into coaching because it's a passion to help other people as we PTs do. What I saw was a need to help others who struggle with identifying the right ideal team players who will they then surround themselves with to help their practice grow and scale successfully. The challenge for us to develop and have the right people around us. Let alone as we're thrust into some leadership and management, we have no training in that. It becomes a real challenge for us because we don't have the skills or the toolkit that allows us to be successful in that realm as well as the clinical realm.

It's one thing for us that we've never been trained in business. A lot of times we think we know a lot about physical therapy, so that we're going to be good clinic or business owners, but we have never had any training in running a business. That in and of itself leaves us ill-prepared and naïve as to the demands of being a business owner. Add on top of that, as you continue to grow, while you can't clone yourself, you need to start developing people around you. An executive team or leadership or whatever you want to call it in order to carry out your vision and your purposes in this kind of business. How do you do that? That's another level of business ownership that we don't quite know how to handle.

That's one of the biggest challenges. As business owners become more seasoned at their business and it's growing their business, they also are looking for ways to quite honestly back away so that they become more visionary and more successful business. How do you do that? How do you back away and then make sure everything else is being carried out to the level that your expectations are? What a lot of my clients are asking about is, “How do I pick who can then start to run my business? I don't want to work in the business so much.” That becomes how to identify who will start to take over some of the reins and responsibilities and tasks to help the business grow and succeed without me having to “micromanage and/or do it all.”

I'm so glad we're talking about this. When I went to PPS, that was one of the most attended sessions that I attended and that was developing your leadership team. I'm glad we're talking about this so that you can give us a little bit of insight and share how do we create leaders within our company, how do we identify them, how do we cultivate them? What stages do we need to start incorporating them? I'm excited to share some of your insights regarding this. I'm sure a lot of other people will get a lot of information from it as well.

One of the first things when you start to think about developing a leadership team is what is a leadership team? What is your vision of what that leadership team will do? How they will respond? How will they communicate? What will they do? Would you always have these visions? You've got to understand what it is about that team? More importantly developing and identifying a leadership team, it can start with one person go to two to ten. Developing a leadership team starts with you as the owner. You have to know who you are, what your needs are, what your wants are, both personally and professionally. What are your values? What do you envision yourself doing as you develop this team? When I worked with owners and their teams, it starts with a basic level of finding out who you are as an owner. What your definition is as a leader? What do you want in a leadership team, one year, three years, five years down the road? Go from there. You can't develop leadership team members if you don't know who you are and what you're doing and what you want first because you become the role model for that. If you have certain triggers, responses and fears, which we all do, those will carry over into a leadership team until you work on some of those particular variables yourself and delineate what it's going to take to develop and lead those other individuals.

Developing a leadership team starts with you as the owner. Click To Tweet

As you're talking about figuring out who you are as a leader, do you talk with your clients a little bit about what their shortcomings are so that they find leaders who complement them? Is that what you're talking about when you're saying define who you are as a leader and what some of your strengths are, some of your weaknesses? What your communication styles are, what communication system you want to use, is that what you're talking about?

Yes. One of the big things that I work on is Energy Leadership Index assessment. That's an assessment. It is not a personality test. It's a dynamic assessment that allows the leadership teams I worked with. They take the assessment. It allows them to determine how they function on a day-to-day basis. What types of things trigger them? What areas they can develop or wanted to develop or improve upon, their communication styles? That gives us a baseline of where they are at this moment and how they respond under certain situations. They can start to work on the development of that. That's where I'd like to start with people because we have certain ways that we respond. People pull triggers on us. As an example, you are in the middle of a treatment and one of your staff comes to grab you and say, "I need to have this day off," and you're in the middle of patients. That's a trigger. There are things that people need to understand about themselves and how they respond so that we can take it to the next level of developing those roles, the role model for the executive team. It is an important piece because you have to understand communication styles and conversations. One of the big things that's a part of this is conversational intelligence. That's a whole other area that I worked on with people and how they developed that conversation that develop and engage teams. It is just a phenomenal stuff.

It's great once you can get a hold of it. As you're talking, there's not a lot of this stuff that is self-evident. You can't look at yourself and say, "These are where my strengths and weaknesses are. This is how I am to people," because you can't have that perspective. When you're in the painting, you can't see the painting as a painter. It's invaluable that you have a coach or a consultant. Someone who has a greater perspective and with the wisdom along with it to share with you. If you come to me with this situation and you said those words, then I would recommend you not to do that. I’ll give you some feedback and help you train on what a proper communication style would be, so you can confront difficult issues and talk through them appropriately with your team members. There's a coaching and consulting at this level and dealing with leadership is invaluable and almost necessary.

I think everybody needs a coach. It sounds funny. Here's the reason why we have such a conundrum for us as owners. We are trained in school and in our training to think for ourselves making decisions. That we have to do things in many times without collaboration because we have to help make those decisions with our patients. We're having to stand back and say, "I need to work on collaboration and bringing people along in this change of what's happening and mentoring these people along not telling them what to do." It’s a whole different mindset approach and learning how to develop yourself and then develop your team. It takes time being a coach. When I work with people both one-to-one and with teams, I don't tell them what to do. My coaching style is to find out what they want, what are their aspirations, where do they want to go with it? From there, people have all the answers. They know what they want, but they need assistance in identifying and giving them a toolkit that they can follow step-by-step. The success is building on the little stepping stones of success not looking at the and saying, "Why am I not there yet?"

It's understanding the process along the way. Yes, it's communication style. It's looking at engagement in teams, engagement one to one. Developing trust and learning how to deal with conflict and not having a fear of conflict. Getting your team on the same level for commitment because there tends to be lack of commitment. The biggest thing is the avoidance of accountability. To avoid holding each other accountable for your teams because what will they think of me? They might quit if I challenge them on this. How do you build those stepping-stones up within the owner or the leader and then the team members, so that everyone has open, honest, trust, vulnerability and can develop as a unit?

PTO 28 | Leadership Team
Leadership Team: It’s hard to hold people accountable when you’re worried about not being liked.


All those things are so valuable when you have a team. The last piece, in particular, hit home with me in holding people accountable because that is so vital but so difficult to do. Most of us, maybe I'm speaking for myself, but a lot of us as physical therapist, we want to be liked. It's hard to hold people accountable because you're worried about not being liked. You want to be the good friend, the nice guy, the great boss that's always positive and chipper. To hold people accountable can be difficult and confrontational and we don't like that, so we avoid it. That's a detriment to us as leaders, but also a detriment to our teams and our executive teams.

The biggest thing when we talk about developing executive leadership and I said from the beginning it starts with us as leaders, as business owners. We have to role model but many times, we don't know how to do that. We feel like we have to always have the right answers. We always have to have a response to questions and we don't. When I work with leaders who get to know themselves, it's okay for them to be able to step back and say, "I don't know the answer to this. Can you help me figure this out?" Learning how to engage, there are rules of engagement. There are engaging others because you have to show your own vulnerability, your openness and honesty in order to start that trust. Trust is the first big thing in a team. You have to develop that, demonstrate that. Otherwise, you can't build anything else into your team without that.

Thinking about that, how powerful would that be if you were humble and vulnerable enough to say when someone comes to you as the clinic owner, who they think knows everything? You said, "I don't know. Can you help me find out the answer to that?” Number one, to show that you don't know everything. Number two that you have faith in them finding the answer for themselves and that shows that we’re part of a team.

Owners and leaders need to get used to opening themselves up and showing their vulnerability even in a meeting. You could go to a staff meeting and say, "We all are here to talk about metrics. We've got some metric problems and productivity problems. We all know that's important for the health of the business. Here's what I'm identifying. I can't figure it out. I need you guys to help me figure this out. I don't understand it. I'd like to have your input." You, right there as a leader are saying, "I don't know the answer. I need your help. I need you're input.” Conflict resolution and conflict in teams is big, but if you don't have trust, you can't open up and deal with the conflict and get away from the fear of conflict.

I want to back up a little bit as we have those leadership teams developing and creating trust amongst each other is the foundational aspect of having a powerful team. How do you identify or even cultivate those leaders talking to those who don't even have leaders or don't think they do? They are maybe a one man show and they're growing, but they need to start divesting some of their responsibilities. How do you identify and cultivate a leader within your group?

You can’t develop leadership team members if you don’t know who you are and what you want in the first place. Click To Tweet

Let's say you have somebody on your team who has expressed an interest and you're saying, "I'm not so sure about this." That's where the open dialogue comes in. I recommended that people sit down and open up a dialogue and say, "Tell me more about how you see yourself in this business? You're in this position now, how do you see yourself currently? How do you see yourself growing with the company?” Get an idea of where people are. Where they want to go? How they might want to get there? Start evaluating just asking inquiry questions. There are several tools that the owner can start to do. Number one, start investigating where that employee feels that they fit into the business. That's critical. Start the dialogue. Have the conversation because then you will start to get an idea of, “Their perception of where they are in this business right now is different than where I think they should be.”

How valuable is that because there are some people who may express interest. There might be those that don't express interest, but you're looking at them like, “This could be a valuable person on my team if I put them in a leadership position.” If you don't have that conversation right off the bat like, "Where do you want to go?" You might be surprised by their answers or if you try to thrust leadership upon them and they don't want that. The conversation is valuable.

That's one of the first things you ask. The next question could be, “Tell me what your aspirations are or yourself both personally and professionally?” Goals are one thing. Aspirations are another. Aspirations are where people feel like they want to go. That's important because if this is an individual that you're not so sure about or maybe you are, either way you need to find out more about where they are now and where they want to go. Get that information. Through the course of that dialogue, there are a couple of tips that you should include. When you're having that dialogue about finding it out, think of this question, “Tell me more.” That's how you get to know people and get to know where they are coming from and where they want to go.

We have employees. They come to work for us to fulfill certain tasks and certain areas that run the business whether they're clinical or non-clinical. This is true for everyone in the business. Learning how to ask specific types of questions that open up the gates of being honest, authentic, open in a safe environment, not a threatening environment. Those are tools that owners need to have so that they can have that conversation and dialogue. The other one is think of asking questions for which you do not have any answers. That's another way to create a dialogue because if you're going to start developing your leadership team and you want to have a team, you need to first get started with the basic foundation, where are these people coming from? Where do they want to go? Those are simple basic tools that they can start with right away to start that dialogue. I have all my clients start with that one. They don't know where to start.

It's a good place to start the lines of communication. With someone who is expressing interest in doing some leadership, what do you recommend the next steps to be?

PTO 28 | Leadership Team
Leadership Team: You can’t assume that the most productive therapist is going to be the best leader and vice versa.


I want to be a leader or a clinic director. I want to be part of this leadership team. The owner would say again to himself, "What do I want out of a leadership team? What does that mean to me? What does leadership mean? What's the difference between a successful leader and a non-successful leader?” These were all things that they need to have in their mind as part of the discussion. Having that discussion, somebody says, "I work with teams like this." They have identified themselves wanting to be a leader. We start by the discussion of, “What is a successful leader in your mind?” Define the positives of a successful leader and then the negatives of what you think would distract from being a successful leader. They define it. Ask them, “If you were to be a part of the leadership team here, what does that look like to you? What are you thinking that would make you a part of the leadership team? What are the tools that you need? What things might get in the way?” Start asking questions so you can get an idea of what they are envisioning because many people bring tremendous ideas to the table. You can build on that and explore that by asking these questions.

Is there a point where you also share your expectations of them as a leader and some of the expectations of a leadership position where you say, “You're going to scale back on some of your clinical hours, but you're going to be expected to be doing more administrative hours and that might take you over 40 hours a week. You have the responsibility for a team now whereas you only have responsibility for yourself in the past.” Do you go through some of those conversations as well?

It starts with what we develop in the process of hiring. We've switched over from job descriptions to job scorecards. Those are where people are responsible and accountable to outcomes not just to actions. That's a whole other thing. If you have a leadership team, you as an owner say, "I don't want to do any more performance reviews. I don't want to do some of the compliance and regulatory things.” More importantly than anything else, “How is this individual going to mentor and build the team that they're responsible for?” The other stuff is easy, that's technical. How are they going to then learn how to develop a team that is under them? You set up structures of meeting with these people regularly. You teach your leadership team how to coach your staff. Coaching them along the way. There are specific tools, questions and processes that they learn so that they can then ask the questions, follow-up, encourage people follow the rules that you've set forth. How do you develop and give them the tools they need to be successful team members?

In our clinics, when we identified people that could be leaders in our organization, we'd have conversations with them but we'd also give them some tasks. We started giving them small things to work on and see how they would perform in those things. To get a sense of how people interact with them as well. It's one thing to be a physical therapist staff, but to assume that a great physical therapist is going to be a great leader that can lead people, that's two different things. Those are two different skill sets. You can't assume that the most productive therapist is going to be the best leader and vice versa. In our company, it’s important to give them some small tasks. Some projects to lead out on whether that's maybe working with a charity or a project that had to do with a community event or something like that. Even though they weren’t in leadership positions, giving them opportunities to do some leadership, recognizing how they performed and if they were up to the task. Is that something that you've also recommended?

The owners have all the ideas and they need help to bring those ideas out so that they can them in a very purposeful strategic fashion that then gets the results they want. Learning how to work, communicate and develop people takes time. It takes ongoing coaching. One of the things that’s so nice is to teach the leadership team how to coach themselves, but then how to coach the rest of the team. What does that coaching mean? You're not just saying, “Good job,” patting people on the back. You're coaching them through all the difficult challenging times because you have set expectations very clearly and concisely on what is expected but how to help them work through that and become successful.

Looking at our past experience that was absolutely fundamental to the growth of our company. My partner, Will Humphrey, he is a natural born coach. He received some coaching himself. As he took on the CEO mantle, he was spending a lot of time with the executive team coaching them on how to be leaders and how to handle those conversations. His main responsibility was the results of the company. After that, it was ensuring that the leadership team was coaching them to be better leaders. There's a huge responsibility there.

When you’re in the painting, you can’t see the painting as a painter. Click To Tweet

It doesn't end. It never ends. You become a masterful leader by ongoing learning and regularly working on those skill sets. You have to make it a regular daily pattern. You reap the rewards when you start to open those gates of communication and conversation and encourage the coaching processes on an ongoing basis. What happens is the stress level reduces, confidence level increase, productivity and performance increase. The growth not only the business but individuals on the team is phenomenal.

One of those hot phrases nowadays is engagement, employee engagement goes through the roof. When you're willing to take the time and coach them on how to overcome obstacles and how to be better leaders and sharing with them your vision. Once they recognize the company's purpose and that it's genuine and honest and that you follow through on your promises, then they become engaged in the company that they are a part of. Those type of people will stay with you and be very loyal because they understand the purpose of the company, but they're seeing it lived.

The thing that's important is we have to be exceptional communicators about the vision not only of the business, but the vision of each of the physicians. Your staff members and team members need to know why they exist on that team. What is their purpose? Everybody in life needs a purpose. If that's clear to them and that is supported and they see the growth forward, maybe the engagement and the level of energy is off the chart.

It does wonders. The amount of productivity, the energy within the company, within the clinic, the individual clinics starts going through the roof and people are excited about the work that they're doing at that point.

Business owners asked me, "How do I develop myself as I develop these leadership teams?" Coaching them on how to coach their team members is phenomenal because they will bring the situations of conflict. Every team has a conflict, has some type of dysfunction. That's human nature. How do you deal with those at the same time you're developing your team? Your leadership team comes to you and asks, “How do I deal with these people that are in conflict over this topic?” As an owner, I would say, “What do you want to have happened to have that as a successful encounter?” They start to solve the problem themselves. Not telling them, but you're continually asking question, what would it have to be to look successful to have that conversation successful between these two or three employees? Then you start to drill down what would you have to do?

I do that even as the coach is reminding yourself as the owner that you might not have all the answers. A lot of times, these people have the answers within themselves. You have to coach it to them. Is that what you find?

That is exactly right. What happens is when you start to do that and ask those questions and engage people, you don't own their negative feelings. As an owner and someone who's developing other team members and leadership and in other positions, we often find ourselves reacting to, "I need to do this. I need to respond to this. I need to give them the answer to this." Our stress level goes up or we start to own their frustration or negative feelings. We, as owners and owner coaches, need to know how to disengage those responses so that we don't take on their level of negative energy on our shoulders. We help them reframe and redirect those questions and responses so that they can look at things differently and the outcomes much better.

PTO 28 | Leadership Team
Leadership Team: When members come up with their own solutions, it’s more than likely that they’ll follow through with solving the problem.


When they come up with their own solutions, it's more than likely that they'll follow through with solving the problem.

They will. It's an ongoing scenario. You have to continue to have those dialogues. One of the things that's critical is with your leadership team and as you work with them from the owner side, you need to set up regular touch points. They may be weekly. They maybe monthly. Touch points are where you meet with people one-to-one and in a group setting so that you are continually touching base with where they're going, what their needs are, keeping them accountable. Not only you keeping them accountable but you're keeping yourself accountable to them as a leader. That's an important piece because it's not one-sided, it's both.

I'm glad you said that because the conversation in those one-on-one is not only, “What are you doing for me or what are you doing for the company?” The follow-up question is, “What do you need from me? What can I do for you to help you? Is there something that I could do to make your job easier or to get that results that you're looking for?”

It is so easy for us to be reactive when we have those questions about the cancellation rates or, “Why aren't you getting people in?” or things like that. That's the accusatory. We have to have the conversation of, “Tell me more about why this metric is showing this number? Tell me what you see that is getting in the way of you being able to meet this metric of what's going on here.” It opens that dialogue and creates that safety net, that openness, that trust that is where these particular conversations and relationships start.

Trust is the first big thing in a team. Otherwise, you can’t build anything else into your team. Click To Tweet

To go back to some more detail, how do you recommend people start building their team? Do you see them starting with maybe a marketing person first or maybe someone like a clinic director over operations? Do you recommend to start from an admin perspective and put someone over HR in hiring, firing, training that stuff? What are your recommendations have you seen in the past?

When I worked with folks, the clients I have are all over the board. One of them might be developing a marketing person and how do we bring that person up to speed in a leadership position? Another is a clinic director. I don't dictate or make recommendations to the business on what they should start with. They come to me and they have to identify what they need, where are their pain points right now. From there, that means that they need to identify, “What do I need? What do I want? Where do I need to start with this? If I need someone to take on more clinical director type of activities, which is a pretty common need, how do I identify that person? What do I want that person to do?” You've got to be very clear on the expectation of what that particular position is required to do.

Looking back on my experience personally if I were to give some recommendations to owners is that the first leadership person you should bring on or train up is in that department that gives you the least amount of energy. The area that you avoid as much as possible, the one that you don't want to do it. For me, it was marketing. I hated marketing. One of my first leadership positions was getting someone to go out market who actually liked knocking doors and talking to doctors' offices. That was my pain point.

That's a good point, Nathan, because strong leaders surround themselves with people who know more than they do. I don't mean that in a derogatory sense, but as you surround yourself by people who are more knowledgeable or skilled or passionate in those areas will make you much more successful business and supplement what you need to have them.

It's such a load off to have somebody go market for me. I could give them directions and sign off on lunches. I'm more than happy to show up for the lunches, but I didn't want to go out and set them up.

That comes because you knew who you were, what your strengths and areas of development. Why put an area of development in something that you have no interest in? Identify someone that can take that on and do that much more probably successfully and effectively. Those are things that owners need to recognize. We don't know it all. We can't do it all. We don't want to do it all but separate the pieces out so you can identify the right personnel to fill and develop that for you.

You become a masterful leader by ongoing learning. Click To Tweet

Anything else you want to share with us, Judy, as we're talking about leadership teams?

Leadership team is a hot topic. It's an area that we need but we're like, “Where do I start?”

If people have more questions, how would they get ahold of you and where do you present yourself on social media?

They can go to my website and on LinkedIn. I am not a big user of Facebook. Just LinkedIn and website and they can call or email me.

What's your website address?


Your email?


Thanks for sharing your insights. I appreciate it.

Thank you for having me. I'm happy to help touch people if they need to. We'll be in touch soon.

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About Judy Cirullo

PTO 28 | Leadership TeamJudy Cirullo has been a very successful physical therapist for 40 years. She has owned, operated 4 private practices with one satellite, one fitness business in 4 different states. She is co-founder of the Aquatic section of the APTA, written 2 books, articles and chapters.
In 2015 she enhanced her partnership of helping others reach their potential by focusing on business owner and team coaching. Her passion for helping others shifted from patients to business owners and their teams. Transforming team members into a profoundly unified team who are passionate about their purpose and unified in their mission.
She develops owners into masterful efficient leaders, and teams into a productive unified group of individuals that propel the business.
He success formula for PT owners and their business has 4 solid pillars that include:
1. Identifying, hiring and retaining the “Ideal tam Player”
2. Ensuring that the owner has the infrastructure in place to support the vision,
3. The owner has the tools in place to evolve as a masterful leader
4. Plans for the future.: silent or absentee owner, selling or shifting the practice to another employee.

Currently her coaching business includes:
• private coaching, 1-1
• Leadership Team Development Coaching
• 5 Dysfunctions of a Team Training and Transformational Training
• Speaking

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