PTO 10 | Physical Therapy Coaching


Not a lot of PT clinic owners are focused on what it takes to create a business that is less dependent upon them as owners. Oftentimes, systems and training, coaching, mentoring, or other accountability methods in order to keep PT clinics in check can be overlooked in the midst of the daily hustle and bustle. Here to share his expertise is Sturdy McKee. Sturdy has built a strong, thriving out-of-network PT business in San Francisco that is not completely dependent on him. There was a time that he couldn't conceptualize that, but it's what some PT owners dream of. Even if that's not you, Sturdy has great advice on how to make your business less dependent on you, the owner. His professional growth and the systems he's implemented have allowed him the time to coach other PTs and business owners. In fact, if you check out his website,, you'll see that he shares some great advice - "Hiring A-players", "New Awesome Intake Form", "The 3 Magic Questions", etc. These resources can help you on your path to making your business less dependent on you.


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Creating a Business That Isn't Dependent on You! With Sturdy McKee

Our guest is Sturdy McKee. Sturdy has been a physical therapist for over 22 years. He is the original owner, co-founder and current CEO of San Francisco Sport & Spine Physical Therapy, which has two locations in the San Francisco area. He comes to us because he has a lot of experience with business coaching and advising for physical therapy clinics. You can find him at We talked about a number of things during the course of the interview. We focused on what it takes to create a business that is less dependent upon us as owners. We went through a few things, but we mainly hit upon systems, training, coaching, mentoring, or other accountability methods in order to keep us in check also meetings and what it takes to hold other people, namely the people within our organizations accountable.

Sturdy has gained a lot of wealth and knowledge through his work with entrepreneur’s organization, which he has been a member of for ten years. You'll notice that he on his own, has reached out, stepped out and networked in order to gain this information and help him improve his own practice. He lists a number of books, a number of thought leaders and small business leaders that are out there that he utilized and implemented it into his practice. I hope you can take a little bit of his information, his experience, and even some of the resources that he used and find a way to implement those same things into your practice.


Our guest is Sturdy McKee from He is a consultant and business coach for physical therapy practice owners and other business owners as well.

Not all of my clients are in the rehab space. I do some work with EO Accelerator as well. Some of the participants in that program are in accounting, data analytics for businesses, dog walking business and baby food business. It runs the gamut.

Tell us a little bit about your story. What got you into physical therapy ownership and led you to where you're at?

I got into physical therapy after having started studying political science and international relations with an emphasis on communist nations. I studied the Soviet Union, Cuba, China and those things. Then, I went to China and lived there for a year. That was my primary reason. I was there learning Mandarin, but in doing that I realized that I didn't want to work for the State Department of the US Government especially in that area of specialty. It'd be very restrictive on where I could go, what I could do, whom I could even interact with and all that stuff.

I came back to the states. I had like so many of us had gotten injured at one point. There was a lot of downtime in the '80s in China. That’s a lot of time to think. I've thought about this PT thing that I've experienced when I was back in Atlanta. When I came back I stopped in California and stayed with my grandparents for a little bit and house sat for an aunt and uncle. I went and got a job as a PT aide. I had several jobs as well. My friends used to make fun of me because I only had three jobs, but they were all in PT.

There was a medical clinic at Stanford where I was an aide to the PTs, OTs and outpatient. I was working at Stanford in the wound care with the PT and that was every other weekend. That exposure and then working in a private practice in Los Altos with a PT and Tom Sutton, I got to do essentially everything but treat patients. By doing the front desk, reception, billing, and everything else, I got exposure to the business. Throughout that whole process, I was taking pre-reqs and going back to school and finishing up a total different path. I have a PE degree from San Francisco State and it took me eight years to get through undergrad that path.

With that experience that you had running the front desk and all the different jobs, did you envision yourself owning a clinic at some point or another?

Yes. Looking back, I always had this entrepreneurial bent. I was in denial and refusing in a lot of ways growing up for all reasons. In any event, I ended up coming back to when I went to PT school, I thought I would open a clinic someday. That ended up happening a lot quicker than I thought it was going to be. When I came out of school, I went to work at St. Mary's here in San Francisco at an inpatient neuro rehab. I did that for a while and then went to work outpatient at Kaiser down on the Peninsula then I worked at UCSF. That was about a three-year whole stint there between those three.

Learning to delegate and learning to follow through and learning to do that efficiently is another critical skill. Click To Tweet

UC at that time had merged with Stanford Medical Center, which knowing all the things I know now about business and culture and the rest of it, it was never going to work. I don't know why they thought that was a good idea. In the de-merger, because they got divorced a couple years later, that all came apart. In that process, some consultants told UC that their outpatient rehab is a cost center and they need to get rid of it. More than two thirds of the outpatient staffs were laid off over the time. I was the last per diem therapist laid off there. I worked for over a year there but I was per diem, but I was fulltime with all these hospital gigs.

When that happened, I went out looking for other jobs and the job market was a bit different than it is. I was disenchanted with some of the opportunities and the things that were out there I came home and rethought it over Then, I bought a massage table and opened up in the basement of a gym in the Castro because a good friend who was a trainer there. That’s how I started. A couple of years later, I teamed up with San Francisco Sport and Spine out of the location and then started hiring employees.

You bootstrapped it to begin with.

Yes, the total definition. A massage table, a cell phone, a PalmPilot back then and I did everything. I did my own scheduling, I did my own billing. I did all of it and it was crazy. You learn a lot from that, but what we realized in opening a third location and hiring employees was that we didn't have any training or background in management. We struggled through that first couple of year’s process.

You opened in 2001.

We incorporated and formed San Francisco Sport and Spine in 2001. What precipitated that was an opportunity to open a location in the Marina District in San Francisco that was separate from but adjacent to the 24-Hour Fitness and keeping on that same theme. It was a separate office, essential upstairs. It was above their studio. The landlord wouldn't want to rent it to anybody else because he had gotten some noise complaints before. All their studio stuff was happening in the evenings and it didn't bother us anyway when we were there.

Through that sublease, we got full access to the gym. That was another great business lesson that we got away from at one point that you come back to is having access and things like that to keep your overhead low can make a lot of financial sense and have the resource. Somebody else is maintaining the treadmill. If we wanted to use any of that stuff, we walk next door. It was convenient. I know there are a lot of people out there with those similar setups and it is a symbiotic relationship.

In incorporating in 2001 you said you got to your third location. How many years did it take to get to that third location or to that point where you recognized and said, “We need some management help?”

The third location was the precipitating event in organizing and partnering up. There were two of us running between three locations and seeing patients. That was when we were hiring people and our first employee lasted a day. Dwayne and I are creating a hiring course now because we've done it wrong so many times. Finally, we've gotten to a point where we have a wonderful team and a great team of people. We're very selective about who comes on. Sometimes that hurts us in the near term financial situation. We got more patients than we have therapists. That's frustrating.

I'm super proud of the people that work with us. It is a great team. A lot of people use those terms. One of my things is I want the team to be happy about coming to work each day. They want to be excited. Everybody says that, but I want them to be excited about who they're working with. If they're not a fit, if there's this tension all the time, what I've seen is that can happen a lot more when you're hiring whoever has a license and is available. There's been a lot of diversity, but not in a positive way. You're not controlling for the behaviors, the values, the vision of things that contribute to cohesion and teamwork.

When you're not aligned essentially and your visions aren't the same, there's going to be a lot of dissension. There's going to be a lot of tension. You're moving in different directions and that's going to create different bandwidths within the company. It can stifle your growth and progress. When that starts to happen, it almost becomes a poison throughout the rest of the clinic to the point where it can affect other employees if you don't have the right ones in place.

I have a process to look at that and analyze it. I have people realize where there are people who lie and why these conflicts are happening and that entire thing too. The irony of all this is if you select people for similar values around the business, in patient care, people for their level of performance and alignment with the vision, you end up with a very diverse group of people who have very different perspectives and viewpoints, but they're all working toward a common goal. That ends up being a dynamic team. There's been a lot of business research out there too about the more diverse your team is, the more diverse their perspectives, the more profitable and the better teams execute. That's very true, but there's got to be that alignment factor on the behaviors, values, and the vision part.

PTO 10 | Physical Therapy Coaching
Physical Therapy Coaching: There's got to be that alignment factor on the behaviors, values, and the vision part.

You went through that hard time where you recognized you needed some management experience or some help of some kind. What was your first step to reach out or step out to get you to the point where you have frankly a ton of stability through your two practices? You have the freedom that you want to be a business consultant as well as still being the CEO of your company. What steps did you take to get to that point and what would you then recommend to others?

I'd recommend they get help and to do it faster.

That's one of the things I'm noticing as I'm interviewing these other successful owners is they say to a tee, they wish they had gotten help sooner.

We did reach out relatively early. We did try to access resources. We're going back seventeen years. There weren't a whole lot of great resources within the profession. A lot of great clinical courses and clinical stuff, but on the business side, we tried a number of different things with other PTs and what have you it didn't click. We weren't making changes and nothing was transforming. It was probably about two years where our wives were frustrated, we were working longer hours and making less money than I have at the hospital and all this other stuff. I came across this course and my first step was Simpleology. It was a business course outside of PT and their applications to life. I've since met Mark and we're friends. I told him when we met for the first time that it was six weeks after doing that course that we were profitable.

Not wildly profitable and successful but it was like suddenly we've gone from hand to mouth, everything was a stressor to "Here we are. We can breathe for a moment." That success with that one thing made me start looking around and going, "If that can make an impact, what else is out there?" I started pursuing and learning, taking advantage of more resources, and engaging a coach. I did the E-Myth Mastery Impact Program with the E-myth. They've changed it up a bit, but they had a coaching program that was very structured, which particularly for me at that time was like imposing structure on my tangential mind was incredibly useful.

From there, that helped us start that whole process of creating systems and having what I call now and borrow from Jack Daly, a playbook for the business. When I reached out to the E-myth and went through that, what I wanted was an operation manual. I wanted our systems and processes to be in place at the end of the fourteen months. The first conversation with my coach Peter back then was he disabused me of that goal and belief that we would get there. He's like, "You're not going to have it finished. Not in fourteen months. It's not realistic."

Is this the playbook that you're talking about?

On the operations like everything systematized and what have you. It’s like, "It's not going to happen in fourteen months. It's unrealistic." We're not reinventing the wheel, but we're creating all this stuff. There weren't like plug and play resources or at least none that I've found at that time. I think of Catch-22 every time I say this or think of it is you're going to have a running start on your operations manual and you're going to have a system to create systems. I was like, “A system to create systems." Ironically, their system for creating systems is super thorough and super in depth. I tend to try to simplify things and take the important pieces and back it out a little bit and make it a bit more palatable, at least the way I do things.

We had ways to identify problems with process versus problems with people. We look at the process. How do you analyze that? What you do about it? How do you create that? If there was one thing lacking in that program that I really worked hard to do now is include the team in creation of these processes and things. With them, it was very much about, "This is the process you need to create, these are the things." I did all the work. Good or bad, it's like you're taking this thing to your team and say, "We're going to do it this way." Of course week in week out there like another, "No, not more stuff, not more new this or change or what have you." Engaging them in those pieces and processes is not only better as far as adoption, it works better because the group has better ideas.

There's some magic behind that when they create the processes and procedures. In my experience, you can't let anybody create the process and procedure. You find the rockstar in their position and you invite them and say, "You do an amazing job. Can you write down what you do?"

That's been interesting too because some people can't. They get stuck there even though they're good at it. If you're asking them to do it and they're not doing it, sit down with them and you write it down. They can get stuck, a little too self-conscious, concerned and whatever versus if you sit down with them and watch them you're like, "Here’s your intake process. Here are the steps you went through." Then, if you want to revamp it or improve upon it of what you, one big key is turn it around from the patient or customer perspective then look at it and say how does it serve them best? That's one of my pet peeves, collecting all the demographic information before you offer them an appointment. I hate that because you have people calling you for help who are literally in pain and are anxious.

Whatever it is you want to do, whatever your goal is, own it. Click To Tweet

When they called the hospital last time, they spent fifteen minutes on the phone and then found out the first appointment was in three months. There's all this stuff going on in their head, whereas if you take that process and think, "What would make it better for them? I got their name and phone number, I'll give them an appointment." We all freak out about it and like, "I got to notice that." Yes, you do. If I tell them, “I've got an opening Tuesday at 2:00. Does that work?” Yes. “I’ll put you in the system. I need your date of birth. Why are you coming to see us?" You're doing all that and you satisfy that anxiety. You have them write it down and get this check off list. That's going to make it easier to train the next person and the next person and to scale it when you open in another location.

What we're talking about how to get you out of being the center of the business, creating some freedom. Not only creating some stability in your practice by number one, setting up the systems in the Playbook like what you're talking about but really gaining some freedom is when those people own those processes and procedures. The training then becomes so simple because they have to follow what's been successful in the past. They don't have to create a new process. There's a checklist or there are outlines as to what they're supposed to do. How you train from there can be in a number of different ways. We find role-playing to be one of the best, but simply work down the checklist, train it into them and start with what has been successful and move it down the line so that you don't have to create the wheel over and over again.

There are two things there. Sometimes we need to be exposed to this same idea over and over before it clicks, before it's the right context for us or what have you. That happened to me with Scaling Up. I was reading and I think for the fourth time before this clicked for me. You were just saying, you don't have to reinvent it, you don’t have to recreate it. You don’t have to figure it out all over again. One of the things in that it says in there is routine will set you free. His whole point and he goes on to explain it and I guess I never read it or listened or it just didn't sink in before, but once you've made this decision that this is how we do this thing, it's decided and you're done and you do it and you do it repeatedly and you can then move on and go to the next step.

If you think you can improve upon it, this is the other half of like Jack Daly thing with the playbook. His whole thing is that most sports teams are run better than most businesses because they do two things. One of them is they have a playbook and the people he worked with, he works primarily with executives and sales and stuff. When they say I want you to help us improve our sales process because he's truly a master at that, he asks them for their playbook. The thing about that is he says only about two out of 100 businesses can hand him their playbook. If you think about your sales process, if you've got all these people doing it in different ways to your point earlier, go figure out what the rock stars are doing and write it down and there's your playbook.

The second piece of what he does is they practice. He literally had an organization of 2,600 salespeople that he built where they all practiced two hours a week. They took the playbook, they identified all the objections and each week they go through one objection with three people. It could be a manager, it could be three salespeople, but one was the prospect, one was the salesperson, and one observed. They rotated and they role-played. They did exactly what you're saying. They role played for fifteen minutes and they rotate after fifteen minutes and then they got to talk about it. No interfering or feedback during the practice. You've got to practice and then you share your observations, you share what you learned. His whole point was if he had a team of salespeople that we're doing that twice a week, every week, what do you think happened to them versus the competition?

They're consistently improving.

Who was the better and who's going to win? The team that practices or the team that shows up and as hasn’t practiced. We end up practicing on our patients or the next person who calls. Your role play thing, that's hugely impactful. You can do that during the meetings. You can do it during group meetings so you can do it over coffee after work or whatever. We practice this stuff in school and then we go out and we don't ever practice again. We get it more information, we take courses and then we'd go and try it on actual people. That's an ongoing practice, refinement and improvement of skills. It might be a little something to consider.

PTO 10 | Physical Therapy Coaching
Physical Therapy Coaching: I want the team to be happy about coming to work each day

You said you noticed after creating some structure in your life with the Simpleology, I'm assuming you saw some immediate benefits as you started incorporating the systems that you were learning or creating with the help of the E-myth people. How long did that take you then or would you say that you're still working on your Playbook or how long did you say it took you that you felt comfortable with to give you some stability and freedom in your practice?

If you think about Burger King, McDonald's or some giant franchise, they're not using the same exact playbook they were last year or fifteen years ago. I don't think it's ever done. You get to a point where it's good enough for where you are, but then you're thinking also is it going to hold up when we go to the next level? That's another thing. If you look in the scaling up, there are some predictable levels and then areas that he calls the valleys of death. Greg Crabtree in Simple Numbers talks about this too where you need these reserves, you need these numbers, need the money, you need the plan to get through the desert, which happens in between. You were talking about reaching out earlier, that's huge because of PTs in particular, but entrepreneurs in general that’s out there in this parallel play toddler mentality. We're all doing things all the time while thinking about it. If we can collaborate and talk to each other, you can learn and make much more progress that way by forming an accountability group. Working with a coach or having an accountability buddy that you talk to. They talk to each other every day, five minutes, but they stay on track with their priorities. What are you going to do?

In doing this, instead of being out there on your own and thinking this is new and unique and you're doing something that's never been done before, it's simply not true. I want to give credit to people who I have learned some of these ideas from. Rand Stagen came out and talked to the EO Group here in San Francisco. I loved what he did because he put a picture of his daughter up on the screen. It was a picture of her when she was like a year and a half and he was like, "She's sixteen now, but I want you guys to look at her because to us she was unique, special, and precious and yet eminently predictable.” We can all relate to this story. We took these courses as therapists, you know when they're going to walk, when they're going to crawl, when they're going to say stuff, when they're going to be able to eat solid food. You know these developmental stages.

They're eminently predictable like your business. We haven't had the business teach course with the developmental stages. We walk into it and see this new thing happening and it's like, "It's a miracle. It's falling apart." Somebody who knows it and has been there or studied or looked at was like, "That's perfectly predictable.” As a quick aside like the stuff you do in a solo practice isn't going to support you when you were with five people. The system has been processed. You're having a place at five aren't going to work at ten, at 20 to 25, at 50, 100, 200, 500, 1,000. These are very predictable stages of employee growth and interaction where the requirements for communication, the requirements for consistency go to another level. What usually happens is we grow past what's working and then scramble to fix it. As opposed to like the Boy Scout motto, Be Prepared. Pack your supplies. Build a reserve to get you through the badlands.

What do you tell maybe the solo practitioner out there who is running ragged and we're telling them, "You need to create systems. You need to reach out. You need to do these things. You need to get a coach." They're barely getting their head above water. They might even be thinking, "Where do I find the time to do that stuff? How do you recommend they start the process to create the systems and to get with a coach and to eventually start stepping out of practicing so they can lead their business?

I'm a pretty firm believer that everybody needs a coach. You can take breaks and that stuff too. We do tend to be out there by ourselves. If it's not that professional relationship, having an accountability group, having people you can go to, having a peer group, which is what the whole thing's about. Having something that you can rely on and go to is huge, it's critical. Part of that is the personal growth and things I've learned. I'm not a big believer that what worked for me needs to work for everybody. That's not the way I give advice or help people. It's like your patients. You figure out what's going on with them and then you tailor it to them. Having that support, that resource in some way, shape or form tends to work better.

Choose your path, but knowing where you're trying to get to and what you're going to do can make everything much easier. Click To Tweet

For that person who's truly solo and scrambling and trying to get everything done, number one, there are so many resources available to you. You can get a virtual assistant overseas for $3 or $6 an hour and then you don't even have any of the employee liability stuff. You start giving things to other people to do. That's actually a big issue with this population. It can be with entrepreneurs in general, but particularly with professionals. Even if there are people who are more mature and older and they’re like, "No, I've learned to collaborate and work together." That's true probably.

Think about the people you’ve hired though, thinking about the young, the new grad, straight out of school. They've been in school for twenty years now, like two decades and they're 24, 25 years old. They've literally been in school kindergarten through doctorate degree of twenty years. In school, what do they call collaboration? If you collaborate on an exam, what happens? That's not called collaboration. They've got twenty years of programming to be right and do it by myself. Then we put them out in this playing field and it's completely different the minute you graduate.

Those aren’t the keys to success.

They'll actually hurt you, inhibit you and hold you back. It's a huge shift in the way people think about it. This is why I'm a big fan of working with and talking with people who played team sports. I mean team sports we had to pass the ball. People get upset about that distinction. The point is even if you've dropped the ball, if you relying upon other people and you've had to do that before, you at least have some framework or context to think about and talk about this. Where you can, then start to translate, "My clinical practice is not school. My clinical practice is more like my soccer team, or more like my basketball or even a cheer leading team or whatever where there isn't a ball."

It’s something around, "I had to work together with other people and we did better when we helped each other," as opposed to being graded on a bell curve. It’s not a competition in that sense. I’m talking even outside of our four walls. If you ask a therapist, who's your competition, they’ll list other PT practices nearby. We only have 5% market penetration. We're not each other's competition. The market is twenty times the size of what we're currently serving, if we could work together to get that out there. I look at things like auto row. Where some people are going to want Hyundai’s and some people are going to want Porsches. That's fine. What if we could all put it there and get people like nowhere to go and know what to do. What if we have a musculoskeletal row where there’s some differences in specialties, visit length and service level, but they get to pick and there are a ton more people out there. Think of it this way. If we even saw a 50% could you deal with or work with ten times more people than you do?

The pond that we work in is so small. It's amazing if we could break through that mindset to recognize the bigger picture that's out and the possibilities.

That's circles right back to that allowing and helping and enabling other people to do stuff. That's true of your business. I talked to business owners that are like, "I have to do this, I have to do that. I'm the only one who can do this." I'm sitting here talking with you. I've got great people running a PT practice that delivers great care and they do a wonderful job. They rely on me for a couple of job functions, I'm selective about what I do and the relevance and importance to the business. Why am I the one who needs to do it? If somebody else can do it, often better then pass the ball. Let them do it. That's a huge shift in mindset.

There are guys out there who are solo business owners, single providers and that are what they want to be and that's okay. They can still benefit from creating systems and processes that can benefit from utilizing somebody to hold them accountable, to make sure that they stay in place or even a sounding board when they have an unruly employee. There's going to be human resource issues.

In every business, by the way.

There's so much more you can do. Your significance in the community is so much greater because you have set systems and processes in place. You've hired the right people. You've created a team and you have the freedom to do what you want to do. It's a stable well-ran facility and if something breaks down, I'm very certain that you have the people to fix it and you might not even know about it. That's the stability and freedom that I think every entrepreneur dreams of.

I used to think so. It certainly was what I thought of. There's a risk in all this. We do tend to project. If it's something I believe in particularly and this is that danger in the hiring process too. If we develop rapport and I like you and you're smiling and all, then my default position is that we're more alike than different. There's no basis in reality for that whatsoever. It's like the real estate adage, you trust but verify. We believe what you're telling me, but we're going to find out. We're going to make sure, we're going to test it a little bit and we're going to see. To that point specifically, there are people who are happy doing what they're doing that way.

There are people who dream of something different. Where the stress and the conflict comes in, I think is when they say they want to do this over here with the freedom and not having it be so reliant but won't give things up. That's again, part of our conditioning and awareness is it the word breaking through that learning to delegate and learning to follow through and learning to do that efficiently is another critical skill. I don't know if we've all done this, but I certainly made this mistake of, "You've got to give stuff up. You've got to delegate." Then doing that but not having a good process to ensure to get it done. We get burned by that a couple times where I did delegate and it all went haywire and I can't do that again. It's like, "I'm never going to do that again."

PTO 10 | Physical Therapy Coaching
Physical Therapy Coaching: Engaging them in those pieces and processes is not only better as far as adoption, it works better because the group has better ideas.

There are other people doing it successfully. That's the thing I look at. Even back, early days of the practice with a few employees and working our butts off I would see there's this one guy who stands out to me. We went down and visited our billing company in Bakersfield. Things weren't going super well. On the way down to Ontario or something to some conference we stopped in Bakersfield. We met not the guy we knew what the billing company who was running it, but the owner.

The owner pulls up in his Range Rover and he takes us to lunch. He's got the billing company and he's got another company and they're organizing a semipro soccer team. They'd gotten the uniforms and he was doing something else. I'm sitting here going, "How in the world could you do this? By the way, you look so chill and have the time to go out to lunch with us.” I don't even know, like I didn't even know how to talk about it at that point. He isn't doing the billing and he's not working in that other business. He's not running the soccer team. I didn't even have the right vocabulary to ask him what was up. How’s he doing it at the time, but I look at people like that and I was like, "I got to figure that out."

Back to your point for the very same reasons, if I have the time, then I can choose what to do with it. If that is to treat patients or teach classes or create content and stuff that I'm passionate about, then cool, go do it. If it's to ride your bike, hike, take trips or go to the kids' practices, you can make more choices around that stuff. You've got to be very clear about what needs to get done in the business. Enable other people to do the things that they love to do and are good at, which is another thing. There are these discussions. Here's a little tidbit for somebody who's struggling with this delegation thing and not quite sure if they want to do it.

There are all these different tests out there that people talk about them being personality tests or communication styles or whatever. They lump them all together and in my experience, they're all very different. They're very different objectives and reasons and stuff. The StrengthsFinder 2.0 by Gallup is a interesting, very inexpensive test. It's not a personality test per se. It’s identifying along the spectrum of 34 different strengths, what your top five are. The cool thing about that is if let's say we did this at one point with twenty people. We did everybody's tests and then we map them on a spreadsheet that they give you, you just plug in. Then you can see where everybody's strengths are and they're like four main categories and then there are these specific things underneath them.

You can reference or use that and look at things that you hate to do or that you dread doing. There's likely, particularly a team that size, somebody who loves to do that. It's like whether it's their job description or not, you could be like, "Nathan, I see that you're good at visual arts and design stuff. I've got this flyer, would you like to do this? Would you mind?" It's not only would they not mind if that's their number one or number two strength or something like, "Yes". By the time they've looked at it, they already have ideas. It's the way their brain works, it's what they do. They're like, "You can do this, this and this." I'm sitting there going like, "Seriously? That was amazing. I can't do that." That would have taken me all kinds of emotional energy and time and effort and learning and Googling and figuring things out.

I still would have done a crappy job versus in five minutes they're like, "We'll do this.” That's one of the reasons I love doing what I do is one of my top strengths is strategic. When you tell me about a problem, I've already got five solutions by the time you're done talking. One of them is probably bad and something you never want to do. Five is not comprehensive there probably 75 different things or whatever, but immediately what happens in my head, I'm already trying to solve it. That was cool as a therapist too because you're presenting and I'm halfway there.

Learning what other people's strengths are and then, working around those different things and figuring out. If you're going to start delegating, delegate the things that you absolutely can't stand to do or that you keep finding yourself putting off. That you don't do very well at all and you're not happy with the work product. Find somebody on your team and if you don't have on your team there is Fiverr, there are assistants, there are other people or your friends. You have people in your network very likely who can and will and will think very little of it because it's what they like to do anyway. You just got to find the right fit.

Getting started, I did not like marketing at all and I did not want to take the time to go see doctors’ offices. When I finally delegated that to somebody, my life was so much easier. After doing that I learned along the way that it was important than to use statistics and have follow up meetings and whatnot. That was where I wanted to go with you next. You're at the CEO level in your own company, but to get to that point, what is your meeting rhythm where you're at and how often do you hold people accountable? Do you have meetings with one-on-one people that you work with? How do you work at it so that people stay, continue to use the processes that were already set forth and are making sure that the statistics aren't going in continual decline?

If a meeting doesn't have an objective, step back and ask why you're having it, what's the purpose of it? Click To Tweet

I feel like we planted this question. The reason I'm saying this is I did a presentation. I have a new favorite talk and I did it for a group at EO in San Francisco. There's a picture on my Facebook page of the group. There were eight or nine people and they are different business owners. It's called Two Things. The first part is, "I taught the course. I don't know why I have to teach a second course because I taught you all this stuff in the first course." It was about raising their profit, number one. We've figured out a way to increase their profit. For those people we were able to figure out $4.1 million in profit. It was awesome. We did that. That was totally cool. Then the thing was you can't run back to your office and tell everybody this is what we're going to do because number one, they'll look at your cross side like here's another tangent, another thing, another whatever.

The second part was exactly what you asked about. How do you make that happen continually and consistently? That is through meetings. The thing I've found is both in personal experience working at other companies as well as doing my stuff and then working with clients is meetings have to have two things. The first one is an objective. There has to have objectives, there has to be a desired outcome. There has to be something you're going to accomplish or achieve. What I say is if a meeting doesn't have objectives, that are not a meeting that's called talking. That's happy hour, but not a meeting.

If a meeting doesn't have an objective, step back and ask why you're having it, what's the purpose of it? If you can't come up with one, then why are you having a meeting? It's a waste of time. Number one is the objective. Number two is the agenda to fulfill the objective. The agenda is the system to get there. Like reinforcing the culture, values, behaviors and stuff in the company is one of your objectives, then telling the core value story early in the meeting and having whoever's reporting to you or if you're reporting to somebody that person share a core value story about somebody else in the company, what the value was, who they were, and what they did to exemplify it.

Then the next question is, have you told them yet? If one of your objectives in the meeting is to make sure that your staff is recognized and you're reinforcing behaviors and culture and stuff that you want, if you've now set up a process where peers are recognizing each other for the great things they're doing on a consistent, regular basis, that's going to help underpin your culture. You create a process around this stuff, and makes sure it happens every week. Then there are other agenda items. What you were saying, how do you get results? How do they making sure they stay on track and do things? That's where the metrics come in but again there are so many little pitfalls here and I know them because I totally stepped in them. I've seen others before and after and the rest of it. If you focus solely on the metrics with many of your employees, the copay collection rate, it needs to be at 95% and it's at 89%, fix it. A lot of times they will get stuck and not necessarily know how to close that gap.

It is important for you as an owner manager to know that there's a gap, but like a lab test or a blood test or something, they’ll tell you where to look next but they won't tell you what's wrong necessarily. Your job is then to go diagnose that. Use your clinical skills, you go to that same thought process and you look what's my differential? I've got these five different possibilities that I'm aware of. There might be others, but I'm going to try to disprove each of these. I need to do that through asking questions and show me.

Show me is one of my favorite things now because what happened is a great question too, but they can tell you where they're like, "Whatever." "Can you show me?" I pull up the copay collection report and I can ask what happened with this patient who hasn't paid the last seven times? What's going on? How do we clean it up? How do we make sure they know what's expected. That they're okay with it, that you're doing it consistently. On my website, I've got these, but they're three magic questions. What happened? When you see that, "What happened?" and stop talking by the way.

In the meetings we tend to do so much of this. We're teaching. We come by it honestly because if you doing your clinical practice, somebody comes in with an Achilles rupture, do they know what to do? Do they have any context that so we teach them about that because we need to impart information so that they can then have this framework so they know what to do next. That's different from your employees and your staff. Hopefully they already know what to do or at least the vast majority of it. Unless they're brand new, they ought to know their job. They know how to collect copays.

What happened and let them tell you. "What are you going to do over the next week to make that happen the right way or cleaning it up or whatever? Then what help and support do you need for me?" Those are your three magic questions. You can get used to and practice those and be quiet because if you're silent and you wait, people will fill the silence. Your job is to not feel it first. If you ask a question, wait for the answer. I've seen it over and over, I ask a question and I'll start talking again because you're not talking. Get comfortable with uncomfortable silences.

PTO 10 | Physical Therapy Coaching
Physical Therapy Coaching: Be clear and honest with yourself about where you want to go.

If we cut to those three questions right off the bat, it would save a lot of time and effort and conversation altogether.

I've watched people go in and I've been guilty of it. If you walk in and you start telling them what's wrong and what they need to do? How does that work? Do they feel appreciated and valued and like they want to go forth and work harder? If you're asking what happened and they explained it to you, "What can you do next week to deal with that?" They come up with a solution. What help do you need from me? "No, I think I'm good. I can go do it." Are they likely to do it? Then it's there, you document. On your meeting agenda, you keep your action items there. What is going to get done by whom and when.

Then you revisit that next week and you tell them, "We're talking and anything you're asking me, can you go visit these three doctors or I’d come up with we need to go out and do more marketing. What are you going to do?" I come up with, "We're going to do a Facebook push, do an email. I'm going to go visit three doctors' offices. When will you have those done?" Your job is just to write that stuff down and then say, "We're going to check on this next week or whenever the due date is." You're comfortable with making sure all those get done before then. That works in a coaching relationship that works if I'm paying you for advice. I'm still accountable. It doesn't matter. I gave you my word. I told you I was going to do this by this date. For most people, that's a reasonably compelling reason to get stuff done.

Is there anything else Sturdy that comes to mind that you want to share with the audience before we sign off?

I was talking with somebody and the thing that was so interesting and he was explaining this to me and I was like hearing myself again, was being clear and honest with yourself about where you want to go. You brought up the idea that there are people out there solo and happy, and there's nothing wrong with that. You're absolutely right. There isn't. If you're thinking you want to do something else, but you really don't, then whatever it is you want to do, whatever your goal is, own it. Write it down, commit to it. Get comfortable with that too, and then pursue it.

If it really is to grow your business or scale, great, but commit to it. If it isn't that, if that's something you heard that sounded cool or whatever, then you don't have to go do that. Choose your path, but knowing where you're trying to get to and what you're going to do can make everything much easier. Then know that there's a process for all this stuff. For that one, if you know where you want to be in five years, then you write down some three-year goals that maybe that way. You write down some one-year goals or milestones for the three or your quarterly goals. This quarter you need to build to get you to the one year.

You need to know your path and I think that goes back to knowing what your purpose is and why you're doing what you're doing, and being certain about that so that you can move forward with some certainty.

Thanks again, Sturdy for taking the time and showing me your thoughts about really stepping out and becoming less centered in your business and essentially making the business less dependent upon you as the owner. If people wanted to reach out to you for further advice, insight and get in touch with you or whatnot, how would they get in contact with you, Sturdy?

The easiest way is through website, my contact page. That's my personal email and it's also my personal cellphone. It's super easy for people to reach me through that and they can text or call or however it's best for them.

Thank for your time. I really appreciate it.

Thank you so much. You, too.

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About Sturdy McKee

PTO 10 | Physical Therapy Coaching

Sturdy is a business coach, entrepreneur and business owner who also happens to be a physical therapist and private practice owner. His “Why” is to help people succeed. He has a special place in his heart for physical therapist entrepreneurs and private practice owners.

As a business coach and instructor, Sturdy brings the practical knowledge of owning, operating and growing businesses, combined with extensive training and learning, to clients who want to improve their business operations and achieve their personal and business goals.

Sturdy created and taught “Clinicient University”, a 2 day business crash course for Clinicient client owners and operations executives. Attendees of this 2-day course realized an average increase in revenue of 8.9% in the first 3 months following attending with the top of the range at 22%.

Sturdy has served as an EO Accelerator Mentor, helping business owners define their vision, mission and values, as well as achieve their business goals.

Sturdy finds immense satisfaction in coaching and working with business owners and executives to help them achieve their business and personal goals.

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