Are you 100% confident that you are collecting every dollar your clinic has worked for? Frequent flyer and CEO of In The Black, Will Humphreys, joins Nathan Shields to challenge owners that any answer other than "yes" is a fatal flaw in your business. He then gives out two more fatal flaws often made in billing and collections that keep you from maximizing your profit. Furthermore, Will shares a couple of things you can do to get a better gauge on whether or not your billing department is working effectively or not.
I've got a frequent flyer, Will Humphreys, on with me again. Will, thanks for coming on.
It's an honor as always, Nathan. It's great to see you. This is how we communicate since you've gone to Alaska is through the show. This is perfect.
That's how we stay in touch. It's our communication time.
These are our catch-up conversations.
You were last on with me for the second anniversary of the show and we reminisced and talked about some things there. In the course of the interview, you shared with the audience what you're doing nowadays and that is your billing collections company. I figured it's important for you to come on and join me because you are seeing things amongst the PT owners that you're consulting and working with that would be valuable to share with the entire audience. Whether they have their billing departments or outsourcing their billing that would significantly improve their gross revenues and net profit margins if they simply stayed on top of them a little bit better. You see some things that if they can focus on those money lines a little bit more, they could generate more cash.
It's interesting you say that because as a private practice owner, when we were in partnership and we were running our in-house department, and at times when we outsourced, we have a specific experience around that. There was an evolution where we bring someone on. They do your billing. Maybe you try outsourcing it a couple of times. It always feels like it's more expensive so you bring it back in-house. After a while, you feel that you've got grips at it. You feel that you have a handle on it. You get to that point where it's becoming this thing that you manage but it’s on the side because your main focus is usually on sales, marketing, and care.
Now that I stepped out of that and I stepped into billing full-time from an outsource solution perspective, I'm doing this thing called the profitability breakthrough audit where people who are either in dire straits and they don't know why they're in dire straits with their billing. More commonly, people who are comfortable, but not confident in every dollar they should. They'll reach out to me and we'll do an audit and it's mind-blowing what I'm learning about billing and collecting from the same call. It's one of those blind spots for most private practice owners.
For all of us, essentially as PT owners, we have no training in how to handle insurance companies and the billing collections aspect and any rules or regulations around it. Most of the time, we naively either bring somebody on, expect them to learn it on the job, but if they've got some experience, we completely trust them to tell us about our money situation. If we outsource it, it’s the same thing. We completely trust them. They've got all the experience to tell us the situation. What's funny is they didn't come at us with statistics and reports that could show their work. They simply said, "Things are going well and these people owe us money and I'm reaching out to them." Even if they did show us reports, we didn't know what we were looking at.
I remember being at those meetings and looking at an aging AR report and listening to my biller say, "This is what this is and this is good." Me going, "I'm making payroll and I'm paying myself. I guess things are great because I remember when I couldn't even do that.”Without proper billing, the money you lose isn't just income; it’s profit. Click To Tweet
“We see our accounts rising and we're covering our bills. Financially, we're okay. There are no concerns and no one's talking to me complaining about their bills. You’ve got it handled.” Can you imagine how much money we lost over the years by taking that perspective?
I got chills when you said that. It makes me sick because the money we lost wasn't just income, it was profit. It was 100% money that would have gone into our pocket. I was barely braggy about how well we were doing in those days. It's scary.
That's money that goes to your household, your retirement and funds your kids' colleges. It could have been another vacation, not necessarily from a self-centered perspective. You could have done more for your business and handing out more bonuses. You could have done more culturally relevant things to enhance the culture of your company, promote people, hire someone on, and do those things. That's all money that went down the toilet because we trusted other people blindly. As you've gone through that audit, can you confidently say that people are losing X amount of dollars or X percentage of their revenues because they're not focused on tracking their money lines?
Yes. We haven't done hundreds of these. We've done twenty of these profitability breakthrough audits. In every single case, even when people were confident that they were collecting every dollar, the least I've seen is $20,000 of profit that was in their company right at the moment that was easy to get. It was right there, "We're doing great." That's the difference they might be doing good. This is this message and I'm hoping everyone will hear this who has any relationship to the billing department, whether it's outsourced or in-house, is that the difference between good billing and great billing is tens of thousands of dollars in most cases of pure profit. It's not any extra work. The purpose of what I want to share is to help people be successful where they are. I believe that PTs can learn the 20% that they need to in order to comfortably navigate and manage 100% of their billing and collecting. At least know what's going on because accountability will automatically result in greater collections.
Can you break it down for us? You've got the three fatal flaws that affect owners and their billing.
As the name of this show, we’re are right into it, three fatal flaws. These are things that I've lived. I want to say we've lived because I don't want to throw you on the bus, but we've lived them. We have gotten them as business owners, but ultimately these are things that have become crystal clear to me as I've stepped into this new role of trying to disrupt billing and that's what I want to do. The whole reason I'm in billing as a physical therapist is to disrupt it because next to seeing our patients and our company's progress, collecting our money should be the best part of our day. It's the worst in some cases because even when we get it, we're like, "Is that all? Is that it? Should I be expecting more?" I want to make billing fun and easy. That's it. The more I've done this, the more I've learned it's possible.
The first flaw that I've seen, both that you and I have lived, and what I've seen with other clients is that people are thinking and not knowing that their billing company is doing an adequate job. There are people who are in dire straits, but over here where most people are, they're like, "No, I'm doing good with billing. Things are going great. I loved my in-house team. I love my outsource solution." When I ask, "How confident are you that you're collecting 100% of every dollar owed to you?" They look at it and that shifts it from being confident. They're more comfortable. Being comfortable is where that blind trust that you spoke of comes into place because it's a matter of like, "I'm meeting my bills. Maybe I'm even running above the 8% profit margin, which is what our industry's running these days. We are either 10% or 15%.” They're thinking, “I'm crushing it,” and there is still $20,000 or more that could be in their pocket or in their house.
That reminds me of the first sentence in Good to Great is, "Good is the enemy of great." If things are going well, “My bank accounts, okay. I'm comfortable paid my house payment, my car payments, my kids, wife, and husband's happy. We're good.” That's the enemy.
Ultimately, that's the first flaw that is totally about mindset. The other two are more specific. I'm excited to share these with your readers because these are tools that I want them to go back and immediately can be more successful. The first thing is the mindset because there's this curtain between PT owners and their money that I didn't see as clearly until I was on the other side of the curtain. I am super incentivized, Nathan, to not show all my cards all the time to my clients, because it makes it easier for me to navigate this crazy thing called insurance reimbursement, which has its own blend of absolute chaos. Insurance companies greatly impact how things come in and if you don't know every little detail and trust that the outcome is okay, why would I provide you with excessive data on that? I am motivated not to do that, which is not what we do. That curtain is there for a reason. People are on one side not trained to run it and on the other side, incentivized not to pull it back for you.
I love the fact that you're willing to share and talk to them about it because there are things that PT owners need to know and do in order to make sure they're tracking all of their money. It doesn't take a ton of effort. It takes intentional effort set aside specifically with the biller at minimum once a month with some follow-ups in between 2 or 3 times. We got to the point where we were meeting with Katie.
I want to throw that out there. The reason things shifted for you and me was Katie Archibald. She is one of your greatest hires. You've made many great hires but one of your major contributions was her. She came in and she challenged the notion. She saw things differently than the average in-house biller. She would sit down with us and say, "I don't think you are getting this. You should expect me to do this." She challenged all of our preconceived notions of production. She was like, "When it comes to this metric, you should expect this, and this metric should be that. If I'm not meeting it, this is what you do." That started the journey of that and that's why I partnered with her in my company.
It was also a matter of, I knew I had the right person because Katie is an honest person and I was able to say, "If you wanted to screw me over and take my money, where would you do it?" We talked about that with the help of Howe, who was our bookkeeper and managing a lot of our financial reports. We started generating reports that would show where every dollar was on every day that was collected across the front desk and coming from the insurance companies because a lot of money is missed there at the front desk. You can all lose some money from the insurance companies but we got to a point where and a tracking system where things all reconciled. We were able to track every single dollar with the reports that they were able to start putting together over time.
It was weird how little it took for us to get there. What Katie did, this is what I'm hoping to challenge in terms of your reader's notions about billing and collecting. There's truth to this. That's why this is confusing is that we weren't trained for billing and collecting. We went to school for something else. We should hand that over to an in-house or outsource solution and let them deal with it. There's truth in that but the problem is that if we are neglecting our accountability to it and we aren't learning the 20% that allows us to govern the process cleanly, then we are beholden of something else.
What I love about Katie is she's incredibly patriotic. She should be comfortable with me sharing this. Her family on the 4th of July, they did a Declaration of Independence in the American History quiz with each other. She's inspiring to be around. She tells me, she goes, "I see what we do as freedom fighting." PTs and PT owners and medical professionals are beholden to what they don't know. The billing companies are like, "Don't worry. We have a proprietary process. It's a secret algorithm." No, it's not. It's something that you can learn.
Those are the mindset, let's get into the weeds. What are the other two things?
The first flaw is feeling comfortable, but not confident that you're collecting every dollar of your schtick. The second flaw is not forecasting your income. This one blows my mind a little bit because any other industry when there's finance, it's like, "If I'm hiring you to go and get my money or I'm doing anything to help an in-house solution, go get my money." Anywhere else, you're going to expect them to set targets for what they do the following month.
If there's an invoice and you're expecting to collect $50,000 and only $40,000 comes in, then you know there's an issue, but we don't do that with physical therapy. We might bill out $50,000 and a lot of times, we don't even know how much we're billing out per month. We're completely incapable of figuring out how much we should expect the next month.
Ultimately, what I mean by forecasting is it is simple math. To take what you've done the previous month and then you multiply that by the average collection per visit. Your billing team should be accountable for that amount the following month. What I recommend is that PT owners, in particular, we at least do a monthly deep-dive where they review the previous month's target and how they did and why they exceeded or didn't exceed that number? They establish a new goal for the next month because the number one metric we don't measure is the percentage of collections of forecasted collections. That's one of the simplest numbers. This does an easy gift to the audience is that most billing and collecting that we do in terms of review is retroactive. It's in arrears. It's already happened. It’s a postmortem. It's too late to do anything about it and meanwhile, by the time we get caught up, those monies are subject to timely filing claims and all these different rejections that ultimately will permanently take our money away.In finance, the empowerment comes through forecasting. Click To Tweet
I did it with my mastermind group and it's surprising how simple it is to the point where some clinic owners are like, "Is that it?" All it is, "What were your total visits in the month of July multiply that by the average reimbursement rate per visit." That's something that you might not inherently know, but you can look in your past months and billing software and simply take your gross revenues divided by your total visits. Do that for a year and then average it and you have your average reimbursement per visit.
Take the month of July. Let’s say 400 visits in the month of July, average reimbursement is $100 per visit. You should expect your biller the following month to collect about $40,000. It's that straightforward and that's your pass or fail. That's your measure. That's your litmus test. I did 400 visits and I know I collect a $100 a visit historically. You should be able to collect $40,000 next month. It's simple and PT owners, aren't doing that on a regular basis because we know reimbursement timing is going to be somewhere between 3 to 6 weeks. It works out over time. It's an easy bar to hold your billers to whether they be in-house or outsourced.
It's easy and it reflects that mindset shift. The first mindset shift is that "This isn't something I can handle or something I can manage that I have to feel beholden.” In finance, empowerment comes through forecasting and often because of the complexities of an AR complex, I'm not saying that getting your money isn't hard because it is but the only way we manage things traditionally is retroactively instead of proactively. As we prepare for growth, as we look for future potholes to step over, being proactive with our finances, by simply forecasting, our income empowers us to know where we're going and hold our teams accountable. It's an easy thing to do when things were a little bit off in our company. We would do weekly fifteen-minute billing meetings that were all about, "This is how much we were forecasting for the month. You broke it down by week and this is how much we collected." You can get in real time, super easy. That discussion alone raises accountability to that team, to where that low-hanging fruit isn't the only thing that they're going for.
Imagine how powerful that makes an owner simply by knowing that statistic. If you know that statistic, I should be collecting $40,000 next month. Hopefully, readers to my blog also know where their break-even point is financially speaking, and know that, “If I'm collecting $40,000 and I know my break-even is $42,000, I've got to get $42,000 to meet all my expenses. I'm going to be at $2,000 loss this next month.” Be prepared for it but at that point, as the leader or captain of the ship, you can start making decisions, “I'm going to have to cut back hours a little bit to make up for this negative that's coming here this next month. I'm going to have to look back at expenses that I can pare down. Maybe I don't buy that piece of equipment this month until we get some positive cashflow in the upcoming months.” You can make a cascade of decisions based on that one metric if you use it so and make you more powerful looking forward, instead of looking back.
It's something that we do organically within our company. It's fun because most of our PT clients that we work with, they're not used to it and half of them don't get it. They're like, "You're telling me how much you should be collecting next month." Initially, they're like, "That's nice." They don't know any difference, but those who've been through the wringer, they look at that and go, "That is helpful to know where my money's at." I would say quickly the one variable in that equation is your average collection per visit, because there are some that go into that from your payer mix to various other factors.
The skilled units per visit that you're doing on the regular and that stuff.
In that case, there are some additional items that influenced this or directly outside of the billing domain but I would say that those are things that can be learned, and the easiest way to overcome that is through networking. This is more of a direction to what you offer in terms of coaching and also with the show is. There's a lot of information out there. It's not hard to get. Information we're sharing here is a lot less commonly known. That other data it's well-known and in your area, what I always recommend is developing relationships with other private practice PT owners in your area as synergistic so that they're not competitors.
You get comfortable if you start sharing this data and although there are still variations on what they collect per visit, having that information, challenges, these preconceived notions we have of what we should be collecting for a visit and maybe it's more. Maybe we're the best in our network, in which case we're sharing with them, what we do that's special on the charges but either way, there's ways to figure out that average collection per visit. Even if it's not where it should be, when you start forecasting, at least, you know what you can expect down the road. That leads us to number three. I felt like that's all I have to say about that.
I usually want to add on, but I'm like, "That's about it."
The third fatal flaw is that people practice owners and PTs are either reviewing the wrong stats as the primary stat or not looking at the right stats at all.
Tell me about that.
The second flaw is the beginning of that, not forecasting and looking at that metric, but in our industry, what's interesting is the easiest statistics to understand are the ones we typically use. Back in the day, the main ones that I would review would be collection per visit, my total collections, and my percentage of collections versus my charges. Those are good metrics. We navigated well before Katie in that. The problem with those is that all three of statistics, and just to go over them in case that wasn't clear, looking at how much we collect per visit on average, what our total collections were and then the percentage of our collection versus bill charges is that they're retroactive and they're not proactive.
By the time we measure those things, we find ourselves in a position where what needs to have already been corrected in some cases can't be corrected. What is the way to go apart from forecasting the right stats for always within the aging accounts receivable? In a weekly process, if that's a brand new term. My biggest concern in doing this show was using any of these terms because none of us have typically been trained on them. If I say aging accounts receivable, there might be a percentage of your audience who glazes over. They heard of it, but they've never had that explained. Maybe they're not even using those other three stats, which are still important.
It's the AR aging report. If you don't know the name of the report, you might've seen it before because your biller or your software is going to show you what 0 to 60 days, 60 to 90 days or 0 to 30, 30 to 60, 60 to 90, 90 to 120 above. You'll usually have five columns of where your money is sitting. You said something important. I want to add to it and that is, there are many times that you can't go back and collect those monies. That's true that it's hard to collect money after the fact sometimes but the other thing to think of is as your money sits out there, it's been shown that you tend to collect less and less of that dollar owed.
If you build for a dollar and you're expecting a dollar, if you get it at the time of visit, you're certain to get that dollar. As soon as they leave the office, the likelihood of you collecting the full dollar changes. The rates come down to you. As a whole, you start collecting $0.86 on the dollar if it's 0 to 30 days. If it gets out to 90 days and 120 days, we're talking $0.30 to $0.40 on the dollar that was owed to you at that time. If you have a $10,000, 120-day AR, you can expect maybe to get $2,000, $3,000, $4,000. That's the national industry average. A lot of times, waiting to collect that money means you're losing pennies on the dollar.
Collecting money is a lot like recruiting. It's all about speed. It's about efficiencies and speed. I look at money like you're trying to recruit somebody. You don't wait a week to respond to their email. You get back right away. When it comes to billing and collecting by virtue of letting it sit out there, it starts to go down, which is why when I look at most of those stats, the first three I do use in a monthly post-mortem like, "This is what happened. This is what you did." In real-time when we do weekly meetings or when we're projecting future income as well. I live with my clients around the projected, forecasted collections, as well as the aging accounts receivable. It's that report that has it broken down by time periods. It can be done differently, but I'd like to quickly review some common breakdowns and what those expected percentages should be.
I have guys in my mastermind and my coaching clients ask this all the time like, "What should be an acceptable 90 days and above or 120 days and above." I'd love to hear what you have to say.
This is going to challenge some people legitimately because the first time I sat down with Katie on one of these statistics that I'll start with the back. I'll go from the end backward. Greater than 120 is typically a category on this report. I used to tell her, I'm like, "Twenty percent is the lowest I've seen it." She's like, "No, Will. You should expect that to be below 10%." That's what I loved about her is she thinks differently. Like, "No, Will. You've got to understand that your aging report is greater than 120 days, that total should be less than 10% of the total outstanding money that's out there.”Waiting to collect money means you’re losing pennies to that dollar. Click To Tweet
When it comes down to 90 to 120 and then 60 to 90, those two categories, you want there to be less than 5% of the total money's outstanding. From 0 to 60 days, we want them to be greater than 80% of our money outstanding. To your previous comments, we want almost all of our money that's outstanding to be in the first 60 days. That's an easy way to understand it. It's sitting there. We're collecting on it. The minor inevitable issues that exist are going to be less than 5%, 5% the pool at the end is less than 10%. It's an easy way to remember it, greater than 80%, less than 5%, less than 5%, less than 10%.
Less than 10% for your 120. Less than 5% for your 90 to 20, 5% and less for 60 to 90. That's a great way. When I pushed people on that or I share that information with them like, "Over 120 days should be less than 10%." They're like, "Wow." There's much money for some clinics sitting out there waiting to be collected if they put in the effort, make a few calls, rebill, send it in with the prescription. Whatever they need, do it and then you'll get your money because inherently, the insurance companies don't want to send you the money. You have to do the footwork. If your biller is simply sending out the claim and it's coming back and getting denied, and they're not willing to put in the effort to do what they're asking you to do, then the insurance company has won and you've lost your money.
The people don't realize there are good people at insurance companies. There are great concepts being driven but when you're on this side of it and you're fighting for people's reimbursement, you see the corruption, the tyranny. That’s why in our company we don't call ourselves billers. We call ourselves financial providers. We do financial therapy. We don't do billing and collecting because we're rehabilitating a broken system. I tell my billers that they are care providers as they help their clients get their money in order.
We only work with PTs because I do think there are variations outside of PT but the similar connection in terms of our healthcare system is the same. We have one group in particular that we submit and get the same rejection notice every time that we haven't submitted things appropriately. We've done this for years and we know. We are submitting things finally we resend the same document and it gets accepted that the policy on that insurance company's end to automatically deny the first time, no matter what. It's interesting to see the game and people’s profits is what they're gambling with.
Knowing this information and then statistics that you shared the 80%, 5%, 5%, and 10% is powerful for an owner to then go to their biller and say, "This is what I expect out of you." Many times, we sit at the feet of the billers and tell us, "Please tell me that it's going to be a good month or that you're not having any billing issues and I can pay my expenses next month." Expecting wisdom to come down from them and tell us how things are going, you're the owner you should know. Having information like this, both the projection stat that you're talking about and knowing the AR aging expectations, it says, "This is what your responsibility is and this is what I expect out of you. You need to make our AR aging reports look like this."
That's a minimum expectation level. There are going to be those outliers that have a ton of lean patients, motor vehicle accident patients, or worker's comp that trail on forever. Those are possibilities, but the biller needs to be telling the owner, "That's why our numbers are off and I need to see each line item of the patient case as to why and for someone who came in for a regular visit and had UnitedHealthcare, there's no reason they should be in the 120. I need to see all of that information." It puts the power back in the owner's desk to know the number one thing you talked about, "Am I confident that my biller is doing everything they can and we're collecting everything we own?"
You and I share a brain because where I was wanting to go with this. What do you ask the readers? What do you do? You're listening to this on the way into work and then you ask your biller for an aging report. You're looking at the percentages and they're nowhere near what we're talking about. What do you do from there? It's all in the story and I'm not talking about explanation or excuse. I'm talking about the objective measurable story around it because any biller worth their salt is going to be able to objectively explain to you why those things are off.
You know the difference without having to know every last detail of billing when someone's making an excuse and dancing versus legitimately concerned because X, Y, and Z are happening. That was what Katie did for us as well. In a perfect world, there is a major variation with that percentage of projected income that forecasted number. It's an easy number. You're looking for 100%. There were weeks or months where we'd be at 120%, but there were months where we're 80% to 90%. Katie would say, "Here are the individual case by case issues we're having.”
Sometimes it was a global thing with specific insurance. Other times, it was a perfect storm of smaller, independent, relationships, and even client issues that were completely impacting that flow for the moment. What cool about it is that if the story isn't an excuse, the action is easy to describe. She would say, “This is what's happening with the insurance. This is what I've done to counter that.” Over time, when I started to trust, that's when we collectively, you and I, knew we were 100% confident that our money was where it needed to be, which was in our pockets. I want to highlight, how do we know this for sure? It goes back to our story when you and I merged with other companies and went to sell our company wasn't the biggest in terms of volume. We had fewer patient visits to our locations, Nathan, than two other locations, but our company was valuated the highest because of our net profits. A lot of it came from this thing that we're talking about.
The focus that we put on it only helped make Katie even better. She's one who appreciated the accountability. She enjoyed putting together the reports and showing her worth and her work. That's the person you want. Not only do you want someone who's bulldogged in collecting every dollar, but also someone who's not wanting to hide and is willing to look objectively at the data and say, "This is what's happening and this is why." Be willing to present and it shouldn't be an emotional conversation, “This is what it is and this is what is expected.”
The thing I want people to realize that most billers and Katie is a diamond in the rough I've learned because she was that person who challenged you and me to expect more and so forth. We've hired our eighth person. We've had eight hires in our company and I could be dingy. For every hire, I'm looking at 300 resumes. What I've learned is that most billers who come across have a high degree of ethics. They want to do a good job where they fall short is in our leadership to them. We don't want to look at it like we're coming down on them. It's not an emotional conversation.
We're freeing them from their environments because most people, given a lack of accountability, aren't going to show up as powerfully. It's not personal. If we give them that accountability, they get to rise up and be the best version of themselves, which a lot of billers I've learned are their personality trait. They're detail-oriented. They want to, "Why would they go the extra mile if you don't know or care?" If you know what the extra mile looks like and you care, you're going to get a much happier in-house biller or a more satisfied outsource solution. I'm hoping to promote these other solutions that exist because there's a great need for it.
There's a certain personality type amongst the best billers that I've had and they take it personally when the money's not coming in. Do you find that? They get mad when they can't collect on that $7.60 copay that the insurance should have paid. They're like, "It's $7.60." They're like, "No, they owe that to us. They need to pay it and I'm going to keep going after them until they do." I'm wasting my money but I love your attitude. We hit on a lot of your topics, but what I love about Katie is also her willingness and insistence to make sure that things were going well at the front desk when it came to over the counter collections too. One of those other statistics was what percentage of the expected copays was collected?
I know a lot of EMRs are set up for that maybe not for that specific statistic, but you can track who should have paid copay and who didn't. That was something that she was able to then work in collaboration with the front desk and especially the front desk managers to make sure that, "So and so didn't pay their $20 copay. You need to call them the day after their appointment and collected over the phone because we're not going to let him walk, wait and hope that he comes in next time and somebody remembers to have him pay $40 next time he comes.” We were dogged about that. We found as we were doing our weekly meetings, that we would also measure that. How much were we collecting over the counter? How much should we have collected over the counter?
Going back to fatal flaw number one, feeling comfortable, “I'm sure that I'm doing well, but not 100% confident.” One way you can tell if you're collecting solution, whether it's outsourced is collecting every dollar it should is that there is a positive relationship between the biller, the front desk, and the providers. There's a natural dichotomy that exists when the person at the front desks errors greatly impacts how its biller performs. It's common. We've seen it 100 times and I had six different solutions in the years. Three of them were outsourced and three of them were in-house. It didn't matter if it was outsourced or in-house if the relationship was nonexistent.
If they didn't have a contact that they felt emotionally like a person that they knew on the extreme other side, where people were agitated by each other, constantly the biller by the front desk and the PT, that's the biggest indicator that you are not collecting everything you should. It takes a team and a village. That's why I think most PT companies prefer in-house versus outsource without even being conscious of it is that it's easier organically to create relationships from the front desk, the back office. They end up running a separate business within their own business, without even knowing it because having relationships organically increases the ability for that company to collect.
If there are any disharmony and lack of clarity when we outsource, that was the most common thing it's like, "I've got this contact name, but I don't know her/him well." The biller that's where Katie shines the most is that she comes in or she came in our case everyone loved her and her team because they saw them as people helping them do their job better. It's a big thing. That's one of the things we do that's different in our company is that Katie harnesses that end of it and then I represent the PT side of it. I've done everything speaking at a team meeting about effective billing practices because the practice was grossly under billing down to 80 holding seminars. We've had those where we've gone into people's clinics and had all the front desks in there either virtually or literally if we can, and describe what's needed because that little bit of information changes the dichotomy increases the connection to the relationship, which brings in every dollar.
We went through this entire thing and you didn't even share the name of your company.Collecting money is a lot like recruiting, it's all about efficiency is speed. Click To Tweet
Isn't that weird? I don't care nearly as much of trying to disrupt the whole damn thing.
There's such valuable information. You wish all the PTs would know it and harness it because it's not hard. They just don't know and you want to get that info out.
To be specific, I'm particular on who we bring on as clients. I don't have a vision at this stage in my career of having hundreds of clients. I rather go a mile deep with people who meet my criteria that I can super meet and help them. I love working with you whenever we've shared clients. The benefit with your coaching with what I do on the financial piece, it's unstoppable. I want to help everybody, but I can only serve. I can go that mile deep with a select few. I want to give information to everyone to be better and more successful and have that freedom against the tyranny of their own and what they don't know. We are looking to take on new clients. Eventually, we've stopped taking clients until October, but we project that we'll do openings in October. My company is in the black. We get you in the black and if they're already there, then we increase the curve of that.
What's unique about it is this whole relationship between me in the back office, Katie in the front office, and then a powerhouse billing team that's 100% American. I've got zero judgment for people who outsource overseas. I think that’s a workable model, but Katie is my partner. We are 100% American. As a result of that, my margins are smaller than others and what I would tell you is that we want to see these companies grow over time. We're looking for long-term relationships and to completely change the dynamic of how people view outsourced physical therapy. We only do PT. We do some OT as well. I will say that but that's it.
That's awesome that you're willing to share because you shared some valuable knowledge so that they can manage their billing department, wherever that is, or their billing person, whoever that is. I know that you're more than willing to do audits with people and share more insight if they're willing to reach out to you. If they did want to reach out to you directly, can they do that?
Yeah, most definitely. It's Will@InTheBlackBilling.com. I also have my YouTube Channel at The Profitable PT. I love doing profitability audits in most cases that help us qualify people as potential clients. I've told people no because of whatever reason, but for me, the owner has to be coachable for this model to work. We don't want customers who want to outsource it and not have a relationship with us. If they want it to outsource and forget about it. There are a lot of good companies that do it. Honestly, I can do a great job. We're trying to go a mile deep. They can reach out to me. I'd love to do profitability audits. In most cases, that's how we found that a handful of our existing clients. I'd be happy to do a profitability audit. We have a system that is super easy. You send your data over. We break it down. I show you where your potholes are. It takes an hour. It's not hard.
Thanks for offering that and that's cool. I'm sure we're going to be in touch again here soon. We'd bounce ideas off each other. It might not be more than a couple of weeks before they hear from us again on the show.
I'm honored. Whenever I'm out and about, and people are like, “Do you know Nathan Shields?” I'm like, "Yeah. He was my partner." I'm not even kidding. It's cool that your show is doing well.
Thanks for joining us. You've made it that much better. Thanks.
Thank you for the opportunity. I appreciate it.
I will talk to you later.
Will is the CLO and co founder of In The Black Billing company and has been a PT for 20 years. He owned a multi-locational outpatient practice for 12 years before starting In the Black Billing with Katie Archibald. He is a father of 4 boys, married for 20 years and a part time comedian. He is passionate about physical therapy, entrepreneurship, and the freedom that is created through profitability.
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My guest is Greg Todd out of Florida. You might have seen Greg around. He's got a ton of stuff going on. He's the owner of multiple PT clinics. He is the Creator of coach and consultant companies called PT Builder and Smart Success PT. He's a mentor. He's a fellow podcaster. He's got a great event coming up. Look out for that. I'm excited to bring Greg to you because in his story, he came to recognize early on in his career, and that was even prior to owning his PT practices, that it wasn't the traditional PT skill set that was going to get him where he wanted to be in terms of success, significance, the effect on his community that he wanted and the wealth that he wanted to achieve, and even the freedom that he wanted to have in his life. He turned to recognize that he needed more non-traditional skill sets and the build-up of those skills. Whether that was learning how to lead others, doing better in marketing and sales or at least having the ability to communicate better with other people and becoming the visionary of his own life and the visionary of the companies that he wanted.
I'm excited to bring Greg to you because it harkens back to the same message that came upon with my interview with John Woolf where we recognized that it requires a change of mindset, that it is not the traditional skill set that's going to get us further as PT clinic owners to achieve the goals that we want to achieve. Read into Greg's value stages that he brings up for any member of a company, whether you're an employee or the owner, and how that correlates to the amount of money and freedom that you have in your life. That's invaluable. He also talks about four different types of people that exist in the world. I'm sure you can relate to all four of them, whether that's yourself or others that you've come across. I will let Greg put his own words to it. Read his story. You will get a lot out of it because he brings a lot of energy and a lot of wisdom to the story and to the message that he's carrying forth.
I’ve got Greg Todd, a physical therapist out of Florida. He is the Creator of Smart Success Physical Therapy and also the Co-owner of three physical therapy clinics and soon to be four. Todd, first of all, thanks for coming on. I appreciate it.
It's my pleasure. Thank you for having me. I appreciate it.
Tell me a little bit about you, Greg, where you started from, what got you to where you are and what you're doing nowadays.
I've been a physical therapist since late 2000 and got into the field because my mom told me to. My mom was a medical transcriptionist for an orthopedic surgeon. She told me and indoctrinated me that, “Greg, you need to have a skill.” She loves her husband but, “Don't be like your dad.” My dad was an entrepreneur and he used to work for a company called Primerica. She says, “You want to have a stable job. You want to have a skill so that you can get a job when you get out of college.” Initially, she wanted me to be an orthopedic surgeon. The orthopedic surgeon that she worked for, the day that I went to go meet him and shadow him, he was in a pissy mood that day. He said, “Don't do what I do. I'm on my third wife. My kids don't know me. Do what they do,” and he had physical therapists that worked in his office.
That is the story of why I decided to go into physical therapy. I knew that I needed to get a stable job because my mom told me to. I knew that physical therapy was in demand. It was between physical therapy and pharmacy. I've always wanted to do physical therapy because I love sports, but I was leaning towards pharmacy because I had a speech impediment and I stutter a lot. I was very afraid that I wouldn't be able to communicate with clients because of my stuttering that I struggled with all my life.
I ended up deciding on PT and that's how I got into it. I was not planning on being an entrepreneur. I just wanted to work 9 to 5, come home and have a good living. I always knew I wanted to have a family. Within four months of me being a physical therapist, I was married to my college sweetheart. I quickly realized into the profession that there was a hard ceiling and it wasn't necessarily the money, but it was the time that I wasn't able to get back with the hard ceiling that I was experiencing. We had our first child and then that turned into two, three, four and I realized that this is not going to work. It's such a hard salary cap and more importantly, it was such a hard time cap. I realized that I was not going to be able to ever win the time game if I was just a staff physical therapist.Communication in the real world is treating everything like an advertisement. Click To Tweet
I thought that I was going to reach my ideal pay by year ten. My first job, I make $39,500 a year. My plan was to make a 4% increase every year. That wasn't bad back then because I was coming out in 2000, 1997 is when the Balanced Budget Act came. You are lucky to have a job. $39,500 and I had a full-time job. I was like, “We're good.” I was making $7 at the most. I'm like, “This is great. No problem.” The issue was that I was under the assumption that you're going to get a 4% increase every year and I had a plan to make $50,000 by ten years. I know it sounds crazy now, but back then that was like, “$50,000, I'm going to get a 4% increase every year. I'm going to hit the corporate numbers. I'm going to hit the company numbers. I'm going to take care of patients. I love physical therapy.”
On my first year, the company that I was working for was a big corporation. They had continuing education courses every single weekend that were company funded and that was within the company because it's such a big company. I did 180 CEUs in my first fifteen to sixteen months. I thought that was the way to achieve the 4%. I had done over 100 continuing education units by month twelve and I've got a 1.5% increase in pay. That was the first a-ha. When I went to my boss, I was pissed. I'm like, “Why did I only get a 1.5% increase in pay?” He was like, “You didn't do anything wrong. That's what we give for staff PTs.” I was like, “How do I get an increase in pay?” She says, “You’ve got to be a clinic director.” Now, I understand how the whole levels of earnings work. It was the first time that I realized you don't get rewarded for being a better clinician in the real world. You get rewarded for moving up in management and you get rewarded for other things, but you don't get rewarded for clinical excellence, which is sad but it's the reality of the situation.
That's no different than being a PT owner. You don't get rewarded for your skill set.
You get rewarded for running the business right, but I didn't understand that and most people don't understand that. If you think about it, it doesn't make sense because we put so much effort into CEUs, into this and that. You've got to get this. You’ve got to do this. You’ve got to become a CSCS. You’ve got to become an OCS. You've got to become an SES. You've got all these different things but nobody talks about that does not get you any closer to having financial freedom and any closer to having time freedom. I went through this journey for about three and a half to four years. My wife and I started to have marital problems. It’s nothing crazy. She was frustrated that I was working so much and that I was on this quest to do every single CEU course there was out there. At that time, I also got the opportunity to work with professional tennis players. I was working on the WTA and ATP tour. I was trying to become an OCS. I was trying to get every single manual therapy certification there was on planet Earth. At the end of the day, I was getting nowhere in terms of earning more and getting more time freedom.
Where it culminated for me was when I asked my boss where I was a clinic director at a brand-new clinic. I had achieved the numbers that they wanted after a year of working in that clinic and gone beyond 50%. I said, “All I want is one day off a week. I want to work four twelves. You are paying me a salary for 40 hours anyway. Let me work four twelves and let me get that one day back so my wife and I can start to spend more time with one another,” because that's where the frustration is coming, that I'm never there. He said no. That was the day that I knew that it didn't matter. I had to become an entrepreneur. I had to go and open up my own thing so that I could be in charge of my schedule. I did not want to do this, but they forced my hand and that's it then.
It wasn't tragic but in a sense, it's a challenge. It’s not even failure but something took you to the point where, “I've got to do something different.”
I’ve got no choice. It was either that or the marriage. They made it very clear. Just to give you an idea of my schedule. People may go like, “What was your schedule like? Was your wife being a brat?” No, she wasn't. Here is my schedule. I started seeing patients at 7:00 AM at the clinic I was working at. This is a company called CORA. I was seeing patients until 8:00 PM. When my tennis players were in town and they weren't out of the country for tournaments or whatever, I was going to their houses or their condos in a place called Saddlebrook after work. It’s about five to ten minutes from my clinic. I was going there and I was working with each person an hour to an hour and a half at a time. I was sometimes leaving Saddlebrook at 11:00 PM.
I’m getting home by midnight to 1:00 AM, eating, then staying up until 1:00 AM and she's asleep. She's waking up to take our daughter to her mom so she can go to work. This was the normal day. Then the weekends were going to Continuing Education Courses. At that time, I was trying to get my Manual Therapy certification to the University of Saint Augustine. That was Monday through Friday for us, then Saturday and Sunday, I was in Saint Augustine trying to become this better clinician. It was a rat race to the bottom. That's all it was.
I love having you on because I'm all about stability and freedom. My story is similar. I wanted stability and freedom, unlike my father. Something that could give me the opportunity to be like my uncles who were in the healthcare profession. They had time and money, and I wanted that. I love having you on because that's what I'm all about on this show. Was it at that time that it finally clicked for you that your clinical skill set made no difference or did that come up a little bit later?
At that time, I started to get it but I didn’t still fully get it. I've started to realize that I was blaming the companies. I was like, “I think they're trying to screw me over. What I'm going to do is I'm going to leave and I'm going to open up my own thing.” I had a non-compete so I had to leave the area for one year and then I came back. During that time, I ended up with this guy who saw that I was working with all these tennis players because the tennis players followed me. He had a very small clinic called Renewal Rehab. He's like, “Let's team up. You will have all the insurances if you work with me.” We decided to become partners. We’ve been partners for fourteen years.
At that point, I still think clinical didn't mean anything and it does mean something. What I did realize at that time was that the corporate system wasn't set up for me to be autonomous, for me to make decisions, for me to do things that I feel were in the best interests of the patient. I knew that at the time. I knew that enough to say, “I’ve got to get out of their system.” I thought that if I went on my own, all these awesome things that I had: OCS, CSCS, all the Manual Therapy courses that I did, and all these different things were going to flood all these people to me. At one point, I was working with three either current or former number one players in the world. I truly thought everybody was going to come to me but it didn't work like that.
You had to come to the realization after stepping aside, working with this other guy and partnering up with him that patients didn't show up, I assume.People are interested in stories. They're not interested in facts. Click To Tweet
There are a couple of things that happen. At that point, I was still working a lot with physicians. I had verbal agreements that, “When I come back to this area, will you send me patients?” They’re like, “Yeah.” Until you come back in the area and you say, “I'm open,” they don't give a crap. There are a lot of things that I had to come to terms with. A lot of PTs think, “If I know this person, if I have this certification, if I do this, if I know dry needling and if I know that, all of these people are going to want to come to me because they are going to want the best.” That's not how it works. That's not how the game works.
What are you telling owners nowadays? What's cool is you're also working with physical therapy students and telling them what the game is like. What are you telling them to focus on? What are you telling them about the system? What do you encourage them to do?
I'm explaining to anyone that wants to get clients into their door, “No one gives a crap about you. They just care about themselves.” That's the main thing you have to understand. The big thing that I'm telling them is everything that's in life or the way that things are with your clients is they don't give a crap about you. They don't give a crap about your certifications. You have to learn how to communicate with them at a very high level. When I say at a high level, I'm talking at a low level. That means we have been trained to communicate the way that we communicate with our colleagues. That's not how it works in the real world.
In the real world, you have to treat everything like an advertisement. You have to talk to people in a way that they're interested in. You have to be able to do things that are going to connect with them for their needs. That's not something that we are trained on. You have to hook people. People are interested in stories. They're not interested in facts. I was trained that the way you need to do it is you need to bring out your JOSPT or the journal article but nobody gives a crap about that. I had to train myself that the higher level of communication is communicating at a third to fifth-grade level with people. That's the big thing that I tell owners. That's what I'm having to do for my clinics and make it very simple for people to understand what it is that we do.
A lot of your focus then is on what people might call soft skill set. It's sales, marketing and patient engagement. It's interacting with people and building relationships.
I'm going to tell you what one of my coaches trained me on. I don't think most people understand this. At my conference, I have him speaking three times because I know that people's minds will be blown once they understand how this works. What he trained me on is that there are four levels of value. We have been trained for our entire life pretty much at the lowest level of earnings, which is implementation. Let's talk about the four levels of value. Implementation is the lowest level. The next level is managerial and unification. That third level is communication and the fourth level is imagination/vision.
Let's break it down. If you take the lowest level, which is implementation. Implementation is somewhat like if you go to a hotel and you want your room cleaned. You want to make sure that your room is clean day-after-day that you're in it. If you check into a hotel and the room wasn't clean, you'd be pissed. You'd be like, “Can somebody clean the room?” That's not a good experience for you. That's a low level of implementation. Someone that's like a maid or a cashier at Walmart. As physical therapists, we are also at the implementation level as well. It is the lowest level of earnings there is. The next level and I didn't realize this when my boss was telling me this in 2001. She was saying, “If you want to get higher than 1.5% increase of pay, you need to become a clinic director.” What she didn't even realize is that the next level is managerial. That is someone that's overseeing all the implementers. You get paid more to make sure that the implementers don't kill themselves, don't kill each other and that they give a good service to your customers. That's a higher level of earnings. Not a lot but it is a higher level of earnings.
In the corporate structure, that brings more value.
When I look back now on my journey in 2004, that was what my boss was telling me. My boss was saying, “If you want to go up in this company, you need to go into regional management.” That's the only level to go. There's no 97110-OCS code. It's 97110. It doesn't matter who does it. It doesn't matter if there's a 97110-eighteen years of experience. It doesn't matter if there's a 97110-36 years. There's a 97110 code. It's just for implementation. There is no way that it's going to pay you any more. What I realized is that if I can go up more in management/unification, which is the second level of value, you can get paid more but it's still a hard cap. There's only so much you can get up the corporate ladder. Here's what I've come to understand. The third level is communication. Meaning that if I can learn how to communicate, if I can learn how to market, if I can learn how to do the hardest thing for any business, which is to get clients and keep clients, it is the highest level skill that you can have.
Think about the people that make the most amount of money in this country. It is the best people that are in sales and entrepreneurs. Entrepreneurs are salespeople. They're selling you on their vision. It is the high-level authors. The first job I ever had was a sales job when I was fifteen years old. I sold newspapers for a company called the Sun-Sentinel. I made $11.50 over two weeks. I sucked in sales. Now, I'm good at sales. I did a webinar and I made $138,000 in two days. It's a skill that if you get good at, you can make a lot more money. I was watching Kevin Hart's Irresponsible tour on Netflix. That guy makes gazillions of dollars by doing a stand-up act for an hour. It's something he's got good at. The best singers make a ton of money. It's all communication. It all falls under the communication umbrella.
They’ve got a robust sales program in social media, you name it, it’s all about sales. You build a brand.
It's all communication. Best actors, best singers, best authors, salespeople are all great communicators. Communication is an amazing skill to have. That's why it's the second highest level of value. Then the top level is the visionaries. It's like this. When you think of Apple, who's the first person that comes to your mind?The people who make the most amount of money in this country are those that are best in sales. Click To Tweet
It's interesting that you didn't say Steve Wozniak, because Steve Wozniak was the person that actually built the machine. You said Steve Jobs because he's the visionary. At the end of the day, the visionary is the one that’s like me having the vision of this program called SSPT. I make the most because I was the one that envisioned it. I was the one that was able to sell the program. I was the one that was able to build a mission and turn it into what it is now. I get paid the most. That's what people don't understand. They don't understand that throughout your entire educational system from pre-K to grad school, you've only been taught at the lowest level. It sucks but it's also optimistic because it's like, “If I go and learn these things, I could accelerate my income and my earnings to astronomical levels.” That’s what I try to teach people.
You had to go down this path yourself to figure it out that you were losing money or at least you weren't tapping into your potential as long as you stayed an implementer. To those physical therapists, I know you've come across them, that are still working on patients, what are you telling them? How are you getting them into increasing their value and getting out of that?
I don't have a problem with people working on patients. The big thing that I need people to understand is that you want to make it a goal to do more things at the higher levels of value than just stay at the implementation level. I'm not saying for people to go from, “I've been treating patients for the last one to twenty years that I've been a clinician and just go cold turkey away.” I'm saying to respect the other things and start to work your way up to those other levels of value so that you can now burst through the ceiling. The reality is most people aren't even paying any attention to it. They're frustrated. They're like, “Why does my career suck? Why am I burning out? Why is this happening? Why is that happening?”
They don't understand those four levels. They don't understand this is how it works. They don't understand that every single CEU course that you go to, what does it teach you? How to implement more. There's no CEU course out there that is saying, “We're going to teach you for a day and a half how to implement, but then we're going to take the other day and a half and we're going to teach you how to communicate what we taught you.” Nobody does that. They don't even know it. I figured it out and it was my coach who put the pieces together for me. He was like, “This is because it's the four levels of value.” I'm like, “That makes so much sense.” That's how my whole career has gone.
Tell me about that a little bit because I'm a big proponent of coaches. You've got to step out and recognize that you're not creating more value by simply treating patients all the time. You've got to be a visionary if you're going to own a practice, make more money and have more stability and freedom. I highly believe that coaches and networking are integral to making those steps. Tell me about your journey towards getting a coach and working with a coach. Did you start right off the bat or did you get to a point where you’re like, “I need some help.”
Let me bring it back to maybe 2004 or 2003. My older brother has always been the entrepreneurial type. I've always been the anti-entrepreneur. That's how it was in the family. I just wanted a stable job. He was always the one coming up with ideas and this and that. He's always been telling me about Tony Robbins, about this person and about that person. I’m like, “Whatever.” I always thought that personal development meant that something was wrong with you like you needed to see someone. I didn't understand the whole thing. It wasn't until I experienced pain as in the way that I thought things were going to work out is not working out, that I started seeking out direction. My older brother was probably one of the first people that I'm like, “Maybe you are right. Maybe I should go open up my own thing.”
From there, I never got my first coach until 2012. I started realizing the power of having how much people knew that I didn't know. I always thought that coaches were CEU like continuing ed people. I realized that there was another world out there that I had not even tapped into. It was in 2011 or something like that when I went to my first real event. I started realizing that there is so much crap I don't know. I started looking, “Is there anybody in physical therapy that does this?” Nope. There's no one in physical therapy that does this stuff. I had to take coaches from outside of my profession, learning and then how can I implement and incorporate this into what I do? That's what I did.
I realized that there was definitely a need to have people that thought the way that my coach has thought and be able to apply it in a field like physical therapy where people have no concept to any of these things. Now, I have many coaches. I have one person that I've employed as more of my mentor and then I have coaches for different things, those different levels. I pay a lot of money to have coaches because I'm realizing that you tell me one or two things and it can be the difference of doubling my businesses. It could be the difference with allowing my missions, all the things that I'm doing to take it to another level. I believe in self-education and I believe it has catapulted my career infinitely more than traditional education. I'm willing to pay for it.
I love that you shared your insight on that and especially what you pay for it. You didn't share dollar amounts.
I pay over $100,000 a year.
I've done the same in the past. What it turned out to be the following year was easily double that in increased revenues. It's funny because I will talk to friends who are like, “I'm thinking about getting a coach, but this guy wants $10,000 for a year and they're hemming and hawing.” I'm like, “You don't even know that $10,000 investment could triple, quadrupled or do more in the next six months to twelve years that you don't even realize.”Convincing is getting you to do it for my reasons. Persuasion is getting you to do it for your own reasons. Click To Tweet
Nathan, I want to tell you something that's important about this. I was Facebook Messaging a guy that's like, “I've been listening to your podcast. I've been doing this and doing that. I'm ready to take this one course that you have. Tell me something to get me over the edge.” I was like, “Here's the deal. I don't convince people. I'm not into that.” I do persuade, but I don't believe in convincing. Convincing is getting you to do it for my reasons. Persuasion is getting you to do it for your own reasons. I need to have you come to the conclusion that this is in your best interest. I'm going to say the reason why people are like, “Yeah, but I don't want to get screwed over by a coach.” I was like, “This is why every single coach I've had, whether it's been a great experience or not a great experience has been beneficial for me.”
We are in a profession where everything that we've done, for the most part, I'm assuming the majority of your audience have only done traditional education. People are like, “How is it that you're able to do all these things?” I have a $30,000 coaching program that people work with me for a year and people are like, “How can you get to the point where you charge that?” I was like, “It's when I started paying for it myself that I realized that my worth has gone up.” I can tell the person like the one you’re talking that's like, “$10,000 or $15,000 or $20,000.”
What I've learned is that there are four different types of people out there. This is something that my coach taught me as well and I will share it with you. There are feeple people, there are freeple people, there are cheaple people and there are premiumple people. This is how it works, but it makes perfect sense. I can say for me, it has changed everything in my businesses when I understood that I've been all four of those people. The first person is freeple people. These are the people that want everything for free. What ends up happening is that when it's time for them to sell anything, they have a hard time selling anything. They're so used to getting everything for free that they feel like a hypocrite for charging. The problem is nobody gets results in them because if you give me free stuff, you don't take it seriously. It's the way it is.
Then you have cheaple people where everything they want are discounts. The thing is when it's time for them to get people to buy into their stuff, they're discounting everything. What happens for them is they're like, “I give so much and I'm not getting anything for it.” Those people end up quitting because they're not charging their appropriate fees. Then you have feeple people. They are people that are comfortable with paying a fee. They don't want to pay for the best, but they're comfortable with paying a fee. What happens is in return, you get people that don't want to treat you as the best. They just want to treat you as, “Okay, you're decent, whatever.” Then you have premiumple people. Premiumple people is where I finally got myself as somebody that used to be a feeple person and now I'm a premiumple person. I’m willing to pay premium for the best.
I have my event and I'm paying someone $25,000 to speak at my event because I want the best. I've looked at my bill so far for that event and I've racked up over $100,000 of bills because I want to have the best of it. I will make a ton of money because I'm willing to accept it. I know that I only give the best so I don't have any hiccups with, “First, he was going to pay me $2,500 a month or $30,000 for the year.” I have no problem with it because I know that I give the best of my people. I don't even know how to not give the best. I've had to train myself to get to that level. I think most people don't understand that and they have this hang-up with selling, “I don't want to sell.” You don't want to sell because you're a feeple person. You probably get everything for free. You should feel awkward. It's like me cheating on my wife and asking her to be faithful to me. It doesn't make sense. That's not how it works. If you're faithful to me, I'm faithful to you. If you love me, I love you. If you don't love me, it's hard for me to love you. That's the way it works and most people don't get that.
It comes back to mindset. You hear about the mindset of abundance and making sure that, “There's plenty of it throughout the world,” instead of a mindset of scarcity, “There's only so much of it out there. Whatever you got, you’ve got to keep it. Someone's out there to screw you over.” Instead of thinking, “There's an abundance of money to be made out there. There's an abundance of love to provide to people. There's an abundance of knowledge to provide to people. We can all share in this boat together.” Switching from that scarcity mindset to an abundance mindset is hard for some people to get over.
I've been there. It's very difficult for people to get over. I'm at a point in my career where I have four kids. My wife's love language is time. I don't have to work anymore. I have an exit plan where I don't have to work if I don't want to. I want to do this but what I have come to understand is my wife would prefer that I hang it up. She's made it very clear. She says, “I would rather you hang it up because you're giving so much to people.” What I've noticed is this. I started Smart Success PT on May 29, 2016. It was for one year that I was coaching and educating people for free.
Do you want to know what my show up rate was for the calls that I did? At this point, I'm only working two days a week in my clinics. I only do evals, everybody else does all the other stuff. I had all this time for myself and my wife, but I told my wife I want to help out this new generation of physical therapists and teach them the things that I've learned. I would block off six to eight hours a week for complimentary coaching calls with me. My show up rate was 30% because I was giving free stuff. I was attracting freeple people and they didn't respect it. What I did was instead of me hitting the dream at 38 years old back then when I started this whole SSPT thing, I was creating another nightmare in my marriage. My wife's like, “Here you are taking time away from me to give to these people that don't even value your time.” Now, I have to charge $30,000 a year because now my show up rates are 100%. It actually saved my marriage. We don't need the money. I don't want people wasting my time.
You have to recognize that you provide value and you’re worth something. There's something to that. There has to be a monetary obligation. Otherwise, people do exactly what you're talking about. They keep in the value of the service that you provide if you're not willing to charge a premium for it. That's a constant battle for physical therapists because at our core we feel we should give away even our services for free. We feel bad asking for a co-pay. We feel bad for asking for a deductible. It hurts to our core to ask people for money. We've got to get over it.
We've never been trained on any of this stuff. That's why everybody struggles with it. They've never been trained on value, personal development, how money works and that you not collecting the money from people is hurting them with regards to getting them to commit. There's so much stuff. Trust me, I struggled with that as well. I struggled with it mightily. Then people are shocked when they get canned. It's like, “They cut my hours. How did this happen?” It happened because nobody paid attention to money. Nobody paid attention to value. “I don't know why patients are canceling. Maybe it's the weather.” No, it's not the weather. The value's not there.
Here's the interesting thing. I give the most amount of free content out. I have 900 videos on YouTube. I've been doing this four to five days a week for four years. You could see that I go on Facebook Live pretty much every single morning and I turn it into a podcast as well. I'm on episode 500 of my podcast. Here's the deal. I give out free stuff because I have made a commitment that I'm going to dedicate six hours of my week to serve my healthcare profession. I'm going to give out but everything else is paid. This right here is one of the six hours. When I and you talked, I knew that I had one more hour this week of my six hours that I give away. I was like, “No problem.” This is one hour but after that, if you want to work with me, you have to pay.
What has happened though is that people have seen, “This guy gives so much value for free. What does his paid stuff like?” It's not a problem for people to pay me money and they pay me a lot of money. It's no problem. When they pay, they realized, “This is worth it.” I've had 475 people take my course. It's the only online course that I've never had a full refund. It's never happened before. It's a $3,000 course. That's the entry level to work with me. The deal is that we have to get over this whole money work that we have. You've been taught that money's evil. You've been taught rich people are stingy, this and that. There's so much crap you've been trained on. You've been indoctrinated on that so that you would stay at the lowest level of earnings, which is the implementation level. What people don't want you to know is that anyone could get to the other higher levels, but then it screws up all the people that are at higher levels. Now they don't have implementers and they're panicking. That's why I'm getting so much flak from different establishments because they're like, “This guy's turning all these people into entrepreneurs.” Now they're all waiting, “Who's going to work for us?” It’s freaking people out. I'm having fun with it. I'm loving it. I love watching all this happen.Your Value, and thus your Earning Potential, increases as you climb up through these stages: Implementor, Manager, Marketer/Communicator, and Visionary Click To Tweet
You're doing great and I love the energy that you bring in. I know that you have a conference coming up. Is your conference a lot of this like how to market, how to sell, how to change the mindset or am I off base? Tell me what is your purpose.
That's what it is. It's called SSPT Live, which is my flagship course, Smart Success PT. The conference is three days. It's based on how I have my method set up for SSPT. The first thing that I believe everybody has to do is they have to calibrate themselves. We have to change their mindset. They've had a worker bee mindset, “This is all I can do,” and we need to help to calibrate people. It's like having a compass. We need to know where we're going first. The first day of the conference what I do is I'm going to show everyone there's not one way to do it. There are many different ways to do it. The people that I've been coaching that are now at a level to where they're at the top 1% in earnings in physical therapy, I've been able to do it for our practice owner, for mobile concierges, for people that are doing online coaching, strictly online, canine physical therapists. I've been able to get all of them, at least one person beyond the 1% in PT.
The first day is about giving you the belief that you can do it in any way that you want. The second day of the conference is about teaching you those higher dollar value skills: the communication, how to be a leader and how to have a vision. That's what the second day is about. If we can focus you on the first day and then we can start to teach you those skills, the third day is about giving you the ability to have a legacy. It's showing you. My whole thing is calibrate, care, create. Calibrate you and getting you focused. Care is showing you the high dollar value skills. They are true care skills that you're going to need in order to win and then create. Create wealth, time, financial freedom. Until you create those things, you cannot create a legacy. You don't have the time to do it.
People say like, “It's such a nice ride.” There are many nice physical therapists out there, but they've never created time and financial freedom. They can't do the things that I'm doing. They are good people but they can't do it because they have never focused on creating time and financial freedom. They can't give back, which sucks. Overall, if you think about it, our profession typically attracts people that are good at the core, but they suck with making money and with knowing how to create time for themselves. They can't do anything impactful.
That's where you see a lot of burnout. You don't see a lot of 40-year-old practicing in physical therapy out there. You get to the 40-year-old mark and you're looking at you can't be a staff physical therapist anymore if you've been a manager for a period of time. There's a hard ceiling there. They're not fulfilling their potential. They're looking for other things. They will get a realtor license or something like that.
Do you want to know what the sad thing about it? When you think about it, the entrepreneur is always telling the implementers what to do. The problem is that in our profession, you don't have enough entrepreneurs. I'm an entrepreneur and I have clinics. Why is it that my employees are happy? They're happy because I am an entrepreneur, but I'm a physical therapist at heart. I want to set it up so that my people are happy day-in and day-out. I have a very unique set up at my office to where the culture is amazing at all three of my clinics. Here's where the problem is in physical therapy. The problem is that most entrepreneurs that are running physical therapy locations are not physical therapists.
They don't have that, “We need to do what's right for the patient, but we need to also do what's right for the physical therapists.” They don't have that pull. What's happening is they're like, “Blue Cross Blue Shield has decreased by 10% in pay, add more patients in the schedule.” Easy fix, go work harder. What's happened is that the entrepreneurs never had that moral code entrenched in them on what it's like the moral code that we have as healthcare practitioners. This is the reason why I'm trying to create many entrepreneurs in healthcare so that when they grow, expand and scale their businesses, they now have already indoctrinated them the moral code of a healthcare practitioner. Whereas if you think about it, most of the people that are running these big organizations are not healthcare professionals. They don’t care. They only care less.
I know you've got to get going. You shared a ton of content. I'm sure we could go down another road with another topic, especially that one in particular. Unless you have something more to share, make sure people get your content or at least your contact information.
You can find me @GregToddPT. That is my handle on Instagram and YouTube. If you want to opt-in to my mentorship list, I send out an email every single Monday called Mentor with Greg. It's something that is on my mind that I feel I can help people. I've been doing it for two and a half years. That's MentorWithGreg.com and you can opt-in to that. My event is SSPT Live. We’re nearing in 500 people for the event. That's pretty awesome. On Facebook, it's www.Facebook.com/ThePTBuilder. I go live at about 7:30 every morning. I usually do a 20 to 25-minute talk of whatever I feel can help people. I also turn it into a podcast and the podcast is called The Hunt for Greatness. I'm everywhere. If you want to binge on my stuff, you can binge on it as much as possible. You will be bingeing for months.
The stuff that you're sharing on your Facebook webinars and also your podcast, is that stuff specific to PT or is it more business in general?
It's for everyone but I have an affinity towards physical therapists. My program has taken in the first five or ten OTs, we have dieticians, chiropractors and we have people that are not even in healthcare. It's going beyond because at the end of the day, if you think about it, no one's learned any of this stuff.
A lot of it is basic business principles or entrepreneurial principles that are beyond just the PT.
It's funny, 10% to 15% of my people aren't even in physical therapy school yet. They're learning the stuff and they understand, “I'm taking this information. I could become a consultant.” They're making money to pay off their entire physical therapy education. I teach people how to create money. That's what I want to teach you. If you can learn how to create it, that money is just exchange. I'm teaching people to be more valuable so that you can make whatever you want.
Thanks for your time. I appreciate it. I wish you the best with everything. I appreciate it.
Thank you so much, Nathan. I appreciate it.
For the past 18 years, Greg has dedicated his life to helping people with the skills that he has learned in his physical therapy career.
In the last eight years, he has helped thousands of people in physical therapy (and now other allied health professions) because of the skills that he learned beyond traditional physical therapy schooling.
This has led him to live the life of his dreams for himself and his family, and now helping others, just like you, create the life of their dreams for their families as well.