PTO 118 | Tolerating Barriers


What are you willing to tolerate in your business?  Substandard performance, misaligned team members, limited time to focus on your business, sacrificing family time for work, unprofitable company structure - these are all barriers to our goals. But they can only limit us and continue to do so for as long as we tolerate them. Inspired by Jocko Willink's quote in the book, Extreme Ownership: "....there are no bad teams, only bad leaders...." Nathan Shields sees that there is absolutely just one thing that is keeping us from what we want. The fact is our team, the economic crisis, the insurance companies, etc. are not the issue; WE are the issue because of what we tolerate.


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One Thing Keeping You From What You Want

I'll start this episode by apologizing. I haven't been on for a couple of weeks and we're getting back into the swing of things. I went on vacation and contracted COVID thereafter. I've been behind on a few things. Forgive me, we're moving on. This episode is not a guest interview like I typically have. It's a solo podcast episode. I'm flying solo because I want to talk a little about something that I've seen both in my own experience and in the coaching clients that I have. It's related to a concept that Will and I discussed a few episodes ago and was then brought up in a different way and in a different perspective. You know how that is. You're thinking about something and then you read it a different way. It gives you further thoughts and ideas. Maybe it even shines a light on what you were thinking of in the first place.

In my episode with Will, we discussed the five secret actions that PT owners take to make them successful. The fifth one that I brought up was impatience. Not that it's a successful action per se, but it's a characteristic that successful PT owners and small business owners have in general. At the time, I didn't feel comfortable with the word because it's not necessarily patience that the successful PT owners are able to make quick decisions with the data that they have. They're decisive. They recognize that there might be repercussions, but they make the best decisions with the data that they have, and do so in a rather quick fashion.

Extreme Ownership: How U.S. Navy SEALs Lead and Win

This concept was addressed in a book that I'm reading. Our Physical Therapy Millionaires Mastermind read together what’s called Extreme Ownership by Jocko Willink and Leif Babin. In reading that, this is what got my brain thinking a little bit, in page 54, he says, “As a leader, it's not what you preach. It's what you tolerate.” He goes on to take it a little further in page 55. He digs a little deeper and says, “There are no bad teams, only bad leaders.”

What I got from that was that Jocko and Leif are stating a better way of explaining that one of five secrets that I discussed and labeled it as impatience a few episodes ago. Jocko might call it intolerance. The idea being that improvement, growth, attainment require us to look at ourselves and our teams and ask, “What am I tolerating? What negative performance or actions am I tolerating that are keeping me from my goals? In spite of everything I have to say and all the values that I espouse, what am I tolerating that's going against those things?” I believe that answering that question and purposefully addressing it head on is the key to our ongoing growth and fulfillment and our successes honors.

It's not a one and done action. This isn't something that you look at now. Maybe you address a current issue and then move on. It's like that never-ending mountain that doesn't have a summit necessarily. There's never a summit to be reached in this regard. Tolerating marginal or negative behaviors in ourselves and others is the antithesis of growth. We’ll continue to be a stumbling block going forward unless we create or develop characteristics within ourselves to not be okay with those things that we're simply tolerating. We could get into a deeper conversation about integrity and character. For the purposes of this discussion, I'll just say that most of the time, the things we tolerate are counter to our stated and unstated values and purposes.

What are you willing to tolerate to keep you from your goals? Click To Tweet

I want to share some examples from my own experience, the experience of coaching clients that I have to illustrate some of the things that are being tolerated. I'm not going to go through the consequences, but consider what those consequences might be if these scenarios are allowed to persist and continue. Usually we consider that it's a team member. That's the “issue.” Remember, there are no bad teams, only bad leaders. Consider what needs to be done as a leader in order for these issues to be addressed. I'll give 5 or 6 here. The PT that's not following train protocol to get full buy-in for the full plan of care at initial evaluation with a patient. Leaving the front desk and patient then to determine whether the patient should come once a week, twice a week, three times a week, and not taking a stand but saying, “You guys figure it out, whatever works with your schedule. We'll see you whenever you need to come in.” Consider what are you tolerating in that situation? What are the consequences if that continues?

What about the PT owner who finds out that, as I've stated here in my show or maybe found it in a different study, but less than 20% of patients complete their full plans of care? That PT owner does a little digging into their own clinic and individual provider statistics, and finds that most of one particular PT’s patients fall off after 3 to 5 visits and are in that less than 20% completed range. These patients are thus not reaching their goals or completing their full plans of care. When the PT is asked about it by the owner, he or she simply says, “I can't control if the patients are coming in or not. If they're busy, they're busy. I don't know what to do about that.”

PTO 118 | Tolerating Barriers
Tolerating Barriers: Tolerating marginal or negative behaviors in ourselves and others is the antithesis of growth.


What are we tolerating? What is the consequence? In that one, I'll tell you the average outpatient orthopedic clinic loses on average $150,000 a year because patients aren't completing a full plan of care. I'll give you that one. What about this? Front desk is found to be collecting only 50% of over the counter collections. That means only 50% of the copays, deductibles, and coinsurance are being collected at the time of service. Typically, this is struggled off by the front desk and maybe excuses are made that the patients forgot their purse or they don't have their credit card on them at the time or, “We'll just let the billing department handle it.” What are we tolerating? A lot of money and what are the consequences?

How about this? This might be a little bit more relevant to our situations. Six months into this economic downturn, there's a clinic that is overstaffed. Reserves are depleting and there's no immediate increase in new patients on the horizon. How much longer do you tolerate the overstaffing and negative profit margins? These next few are owner-specific. An owner has a team member that complained about their pay, their hours, even asking if meetings are on the clock or not. It's gotten to a point and sour the relationship to a point where this team member now avoids interaction with their supervisors and even the owner. However, they're productive and their patients have no complaints. Is that conduct tolerable? Are we tolerating something? What are the consequences?

The last one I'll share, all of your physician only marketing efforts have led to a stable yet a plateaued number of new patients that come in the door. You, the owner wants to expand, but you don't know what to do and don't have the time and effort to do it because they’re too busy treating patients full-time. You don't have the time to necessarily assess the alternatives because that takes even more time away from hobbies, family, etc. What are we tolerating and what are the consequences?

“There are no bad teams, only bad leaders.” – Jocko Willink & Leif Babin Click To Tweet

Most of these are real situations. Some are mine. Some are clients’ situations, but in each situation, I can promise you that the owner is tolerating the inaction of the employee or of their own that goes against their clinics, values and purposes. It’s going against what they preach. Remember, it's not what you preach, it's what you tolerate. That's where this whole conversation came from. Successful owners who have gained experience and have learned over time, they don't tolerate the affirmation scenarios.

They usually follow up pretty quickly with a four-step process and don't drag things out. Number one, they assess, revise and update any training or protocols that need to take place, and assess the situation to see what was missed in the training, what was missing in the protocols, or if the employee simply didn't follow through. Number two, they commit to change and improve both personally and as a leader of their team. Number three, they commit and expect higher levels of performance of themselves and others. Number four, they follow those commitments up by acting according to a higher standard and tracking the statistics that are related to them to that higher standard, and doing regular assessments either with themselves or with team members or in their leadership teams.

In the book, Jocko Willink says, “When setting expectations, no matter what has been said or written, if substandard performance is accepted and no one is held accountable, if there are no consequences, their poor performance becomes the new standard. Therefore, leaders must enforce standards. Consequences for failing don't need to be immediately severe, but leaders must ensure that tasks are repeated until the higher expected standard is achieved.”

PTO 118 | Tolerating Barriers
Tolerating Barriers: Successful leaders act quickly and decisively and don’t tolerate substandard performance.


What we tolerate leads to poor performance and that poor performance becomes then the new standard. The question is, what can you see in your clinic or in your own personal lives that you're tolerating that needs to be addressed? Simply address that now for immediate improvement. That's the challenge. I can think of a few things myself and they're not easy solutions. Nevertheless, if addressed, I can see the possibility for growth, fulfillment and attainment.

That's obvious if I simply address those things appropriately. I offer you that challenge. Open your eyes, pull your head up as the leader and be honest with yourself. What are you tolerating personally and professionally? Make a plan for immediate correction, including putting on your calendar exactly the hour and the day of when that item will be addressed. This is how successful leaders operate. They act quickly and decisively. They don't tolerate substandard performance.

If you are treating patients full-time, that doesn't give you the opportunity to assess and address your business accordingly to see and act on those things that you're tolerating. I challenge you to do those things. Hopefully, everyone's doing well, especially as we're recovering from the pandemic. I hope to see you here in the near future with another exciting guest, some great resources and content coming up. Stay tuned. I'll see you next time.

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PTO 30 | Business Coach


Jeff McMenamy, OT, and Dr. Sabrina Starling (from the previous episode) join me in a conversation about Jeff's success and how his success is directly related to the business coaching that Dr. Starling provided and continues to provide him. Jeff started his clinic in a two-car garage and now owns four clinics across Wyoming - Teton Therapy. His life changed forever when Dr. Starling asked one question. Take a listen to the episode to find out what it was (mystery sandwich!). Jeff attributes a great measure of his success to the coaching he's received, and I am in complete agreement. Lesson of the day - get a coach!


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Small Business Essentials - A Business Coach: Conversation with Coach And Client, Jeff McMenamy

PTO 30 | Business Coach
How to Hire the Best: The Rural Business Owner's Ultimate Guide to Attracting Top Performing Employees

With this episode, I'm excited because I've got three people on the line. One being myself but also a friend of mine, Jeff McMenamy, a successful physical therapy owner in Wyoming and his coach, Dr. Sabrina Starling. Dr. Starling is the expert in recruiting top talent and has a book called How to Hire the Best, which you should look into. Jeff got me in touch with Dr. Starling and I thought, “I'd like to have Dr. Starling and Jeff on the same episode, so we can discuss the benefits of having a coach in your life as a physical therapy practice owner.” Jeff, not only is inspirational in regard to the fact that the guy started in a two-car garage with his therapy clinic and is now the owner of four physical therapy clinics across Wyoming. A lot of that has been due to some of the consulting he received and the individual business coaching that he received from Dr. Starling. I thought I'd bring the two of them on together to share what it's like to work with a coach and how it helped Jeff go from two-car garage to a four-practice clinic owner.

Jeff is the CEO and owner of Teton Therapy, which provides both physical and occupational therapy services. They have four outpatient clinics in Wyoming. These clinics aren't close together. They're roughly four hours away from each other, but they still see roughly 600 visits per week combined. Jeff has full control of them and continues to succeed and continues to have plans for expansion. He started into private practice on his own in 1999 and joined up with a couple of physical therapists but eventually became the sole owner of Teton Therapy. He's originally from Minnesota, but he has called Wyoming home for years. He loves it because of the outdoor recreational opportunities and the spirit of the people that live in Wyoming. He and his wife, Mic, have three children. They are empty nesters. Jeff retired from coaching ice hockey and is planning to spend his winters in a warmer climate, but still managing his company from a distance. That's the goal of all of us is to be able to have such control that we can manage our businesses from a distance.

Dr. Sabrina Starling has been coaching for years. She's a clinical psychologist and is known as the business psychologist and author of the series How to Hire the Best. She's also the Founder of Tap the Potential business consulting, which essentially focuses on transforming small businesses into highly profitable great places to work. Her experience working with entrepreneurs in rural areas catapulted her into becoming the world's leading expert in attracting top talent in small businesses especially in rural areas and thus brought about the How to Hire the Best series. She also has a podcast called Profit by Design.

In this episode, we're going to focus on some of the benefits that come from coaching and some of the experiences that Jeff had in working with Sabrina that led to his success. I want you to know his story about the one question that Dr. Starling asked him that catapulted him into success. He'll share that question with you. The one question that she brought up that struck a nerve with me was, “What if it's not true, all the fears, all the things that hold you back? What if those ideas and postulates that you have in your head aren't true? What would you do then?” She also asked another question of Jeff that catapulted his growth. These are the some of the things that coaches do for you. They open your mind. They ask open-ended questions and help you come up with the answers from within. It becomes more successful in that way and becomes an eye-opening and mind opening experience.


I'm excited because I've got one of my coaches that I've interviewed, Dr. Sabrina Starling and one of my good friends from my network and a successful physical therapist, Jeff McMenamy with Teton Physical Therapy in Wyoming. Jeff has worked with Dr. Starling over the past number of years. I thought it'd be great to get the three of us and talk a little bit about Jeff's story. Thanks for joining me, Jeff. I appreciate it.

It’s nice to be here.        

Dr. Starling, nice to talk to you again. I appreciate you taking the time.

I'm delighted to be back. It is fun to be here with Jeff. Jeff introduced us together, Nathan. I’m glad the three of us are getting to sit down and talk.

Jeff was great. He said, “If you ever want somebody on your podcast, Sabrina would be great.” We talked a lot about attracting recruiting top talent and a lot of that came from her work in this small town. You were in the same small town at the time weren’t you, when you were working with Jeff initially?

Absolutely. Jeff was one of the business owners who inspired that book.

The book that Sabrina is referring to is the book that she wrote called How to Hire the Best. If you're looking to get some strategies and ideas on how to recruit and hire, be sure to look for that book on Amazon or you can go to her website, She's got some extended webinars and training on doing that. Does that sound about right, Dr. Starling?

Yes, that's all good.

Jeff, specifically I want to take this interview to talk about you and your experience working with a consultant. To have both of you at the same time would be a cool thing to do. Jeff, do you want to share a little bit about your story and what got you to where you are now?

I was working for a large corporation back in the early ‘90s. It was roughly about 1999. I had it with big corporations and so forth. Though they treated me well, I felt like I wanted to do my own thing. I'm an occupational therapist by trade. I decided to go into an outpatient setting not knowing anything about what I was getting into. I went ahead and rented some space at a little place and eventually joined up with two other physical therapists. I ended up through time buying both of them out and then becoming the sole owner of Teton Therapy. That's where it all started. I didn't have much of a plan. I knew I wanted to work for myself and create my own life and my own career has taken off from there.

If you had all the courage you needed, what decision would you make? Click To Tweet

You've done great. You're the perfect example of a successful small business owner, not just a physical therapy clinic owner but a small business owner. The first thing that came to my mind is how big was your space when you first opened up?

It was a double-car garage that filled in the doorway with a wall and a window and then carpeted it and painted in the sheetrock. That's what it was.

I never heard of a physical therapy clinic inside of the garage.

It was in the back of a doctor's office and that's why we went into it. The doctor was right there and he was willing to rent us some space.

Where are you at now? How many clinics and what are their sizes?

We have four clinics. We've opened up five and one of them went with one of my partners. The current clinic we're in, Riverton, is 5,700 square feet. Lander is about 3,500 square feet. Cheyenne is the same. Sheridan, which opened in 2016 is right at almost 3,000 square feet I believe.

Big changes and big growth from the two-car garage.

After the two-car garage, we were in a racquetball court.

I can verify that, Nathan. When I first met Jeff, he brought me into his office in the clinic that was in the racquetball court and his office was like a closet. He had metrics and numbers all over his wall. That's when I knew that he's not going to be staying in this clinic long this way.

You knew you had a gem to work with at that point, I'm sure?

I was reassured that it’s going to go well from there.

Jeff, when you introduced me to Dr. Starling, you said that she asked you a question that blew your mind and led you down the path that you've gone now. Do you mind sharing what was that question?

She asked, “If you had all the courage you needed, what decision would you make right now that would have the greatest impact on your business and your life?” She discussed more on that, our voices of reason and so forth that they hold us back. That was on a free webinar. I didn't know Sabrina. My wife had set it on my desk and said, “I think you should attend this thing.”

If you had all the courage that you needed, what decision would you make? Is that how it went?

We get in our own way all the time as business owners. Click To Tweet


At that time, were you struggling quite a bit or were you looking for something?

I wasn't looking for anything and I was pretty happy with where I was at, but it was a very freeing question because I thought, “If you had all the courage you needed, there wouldn't be any risk.” When she asked that question, I took it in that respect of, “No risk. Big decision.” The follow-up question was, “What's preventing you from acting on that?” It was thrown out there as a group question. It wasn’t to me individually. She asked for anybody in the group if they would be willing to share.

Did you immediately come up with a couple of things that you'd say, “I would do this and I would do that?” Was it pretty obvious?

It was obvious to me that we were facing renting the next racquetball court over trying to figure out how you put a hole in a racquetball court wall because they're very heavy walls. It was evident to me. I was like, “We need to go find some new space and maybe even purchase a building.”

Did you eventually do that?

PTO 30 | Business Coach
Business Coach: We put ourselves as business owners inside little boxes all the time. That is why so much of coaching is about getting out of the box and looking at other possibilities.


That day I told Sabrina on the call, “There's a building that had been up for sale for quite some time.” It's on Main Street and it’s the current location that we're in. I said, “I'll go make an offer on that building. I would make a low offer.” I went ahead and I remember I was getting ready to leave the next day for a hockey tournament. I was playing in myself in Las Vegas. I thought, “I'm going to go throw this offer before I leave tomorrow.” I didn’t consult with my wife or my business partner. I told them before I was going to do it. I said, “I'm going to go make an offer on that building on Main Street.” They said, “We haven't talked about this or anything.” I said, “Don't worry, it's going to be a very low offer. What's the worst thing that will happen?” The worst thing that could happen was they would accept the offer.

They did?

They did.

I assume it ended up being a good thing.

We saw a six-month growth from changing the building, opening our space up.

Even coaches need coaches because no one can shine the light on their own dark corners. We need somebody outside of us who can do that. Click To Tweet

You're still there now?

Yes, we still have it but I have another corporate office that we've been in to do more of our administrative stuff.

I have to say when Jeff told me on that webinar that he was going to make an offer on that building, I thought, “What have I gotten this poor guy into?” As Jeff reflects on this, what I'm aware of is that he was playing it safe when he was looking at, “How do I put a hole in a racquetball court and expand that way?” That was him looking at, “Here's where I am, here's the little box I've put myself in and our company and I'm going to keep playing safe. How do I expand from this little box?” We do that to ourselves all the time. We put ourselves as business owners in these little boxes. Much of coaching is about getting out of the box and looking at other possibilities. From Jeff, that question helped expand his possibilities. It put fear on the back burner and it made it not so important to play safe. To hear him say, “We grew from there,” and the level of growth, he did. I remember it was rapid growth from there. Metaphorically, they came out of their box and Jeff and everyone in their business, their mindsets opened up the possibilities.

I don't think that's limited to physical therapy owners. That's something that you see across the board, Sabrina, that is fear gets in the way so much of what we do.

We get in our own way all the time as business owners.

Are there some commonalities that you see among physical therapy, clinic owners in your dealings with them in the past?

Yes. One is working in the business and feeling like I am the one that needs to be delivering the service. “The patients like me, they don't want to talk to anybody else. They want me, so I need to be there or I'm the only one who knows how to do this. It means I have to be doing this.”

How do you break them from that? How do you get someone out of that box?

PTO 30 | Business Coach
Business Coach: When it's dark, you might only see the exit in front of you.


The, “What if it's not true?” question is a powerful question. We have to listen to ourselves and we're not good at listening to ourselves. It is much better to have other people listening to us and pointing out, “You just said,” and what if that's not true? As a coach, it's always a little precarious to ask the client, “What if what you said is baloney?” You don't want to say it like that, but from a curious place like, “What if this is not true? What if these are beliefs that are limiting you and holding you back? What other alternatives and what other realities could you be operating from that would serve you better?”

I'm sure that leads to all kinds of conversations and ideas that come up as you're coaching these people.

When I threw that question out on the webinar that Jeff was on, I had no idea where he would take it or where anybody on that call would take it. I knew for myself that when I'd heard it, I knew my answers and it got me out of playing safe and looking at other alternatives. I thought, “If it helped me, it's probably going to help people.”

As you've worked with Dr. Starling in the past, Jeff, what are some things that you found that she's been helpful in guiding and directing you as you've worked with her?

When we both have worked with Measurable Solutions and it's all about growing your business and getting other people to get the work done. One of the things that Sabrina started with me was business coaching. The business coaching wasn't just about coaching through business. Probably more of our time was spent coaching me through different life issues because your business and your life is so hand-in-hand. With that coaching, I started to self-coach. I would run into a problem and I would call Sabrina right now, “What would she ask me?” They were always open-ended questions. You were never going to get an answer from Sabrina. I'll tell you that valuable time of contemplating what she was going to ask me and then we would get into our coaching sessions, it taught me how to be a coach. That training that I had with Sabrina, those real-life experiences also going through the coach approach training with her, I use that every day. I have other business partners in some of our other clinics. I see that from that outside perspective. I have to make them get through their barriers and helping to coach them through. It’s a skill. It takes practice. It's definitely a technology and it's so valuable to grow your practice because you're growing other individuals.

It’s so fulfilling when you're able to do that, don't you feel, Jeff?

It's not your answers. It's their answers. They're accumulating the wins when they make the right decision and they experience something new, just like when I experienced purchasing that building and seeing the business take off. That's like winning a big game. Now you're ready to take on stronger opponents. That's what's so fulfilling about seeing some of these other younger partners and younger therapists and so forth that have the same dreams that I had and watching them succeed and take off.

Do you find, as you've done more coaching, that retention of these key and A-players has improved?

Definitely. Some of the executive council that I have around me, they know they're learning more about coaching as well. They may ask a question and they’re like, “I know you're not going to answer it, Jeff, but I'm trying to think of what you're going to ask me.”

You're replicating yourself and that's exactly what you want. I want to turn that over to Sabrina. Is that your goal to help your clients eventually become coaches within their own company?

Not just my clients and the business owners, but their entire teams learning how to be coached as with each other. One of the things that I have come to appreciate coaching and when we ask open-ended questions versus what a lot of people think coaching is, is telling someone what to do. I coached them to go do X, Y and Z. That's very different. If I had been in a conversation with Jeff and he had said, “We're growing and our space is getting cramped in this building.” I would've said, “Jeff, I think you need to place an offer on a bigger building.” Immediately, he would have gone into why that would be not a good idea. He would have told me, “This is crazy.”

The Gremlins are the enemy of change. They come up because we're on the cusp of doing something great. Click To Tweet

“I can't do it because of this, that and the other.”

We resist advice giving. That is our human nature. It can be the best advice in the world and we will resist it. That's the hard thing for me as a coach, especially when I'm talking to people about hiring because that's an area where I have a lot of expertise now. Sometimes I absolutely know the answer. I know what they should do and if I say, “You should do it,” I get the resistance. What we've done now is we have our clients in small groups with each other. When other clients share their experiences around hiring or their experiences around, “Here's how I did this in my business or here’s I became more profitable,” that's where people start to pay attention and get curious. It's that combination of experience sharing and asking the powerful questions. I love what Jeff is saying about his executive team when they're all coaching each other because there's that opportunity for those other team members to be sharing experiences and asking the powerful questions. It's not just up to Jeff to be asking those questions.

That's been going on for how many years now Dr. Starling?

Off and on, probably from 2006. Jeff, do you know?

It's probably right at about 2006.

Are there some points where you felt that Jeff needed to make a course correction? From a coach's perspective, how do you go about doing that?

Yes, there were points where I wanted to give him advice. The analogy that I use is like we're going into a dark room with a client and we're trying to shine the light on all the different corners and the exits from that room. When it's dark, you might only see the exit in front of you. The asking the questions helps to shine the light on other alternatives and other possibilities that the client may not be seeing for themselves. That's so important for all of us to be aware of. Even coaches need coaches because I can't shine the light on my own dark corners. We need somebody outside of us who can do that.

Coaches are so huge. One of my recommendations for any small business owners is to get a coach or a consultant. What would your recommendation be then, Sabrina, if someone like Jeff or any small business owner is looking for a coach whether that's you or somebody else? A coach is going to help no matter what, but which ones might work out best and what should a person do to look for the one that does fit?

Ultimately when you're looking for a coach, you want to find somebody that you're going to have a good rapport with. That is first and foremost. Look at the other clients that they have served. Do you look like their other clients in terms of not physical appearance, but the situations that their other clients are in and the results that those clients are speaking to? Do you resonate with those? Do those results match up with what you're trying to achieve? We deliver life-changing business transformations in my coaching company and not everybody wants a life-changing business transformation. They just want to grow their revenue. We're not going to be the coach for them. It comes down to looking at what the results that the coach and the coaching company is promising, your ease and comfort with them and the alignment of the values. The previous clients and the current clients, do you fit with them? Is that the right fit for what you're looking for?

Jeff, from your experience, what were some of the biggest benefits of having a coach on your side?

As a single owner, it was having another perspective and it wasn't somebody that I was paying as an employee who is going to give you lip service of what they thought you wanted to hear. It wasn't somebody like my wife who has the same perspective that I do. Also, it wasn't somebody in my own field that might be steering me in some way. It was somebody who was very neutral and was looking out for my best interests. That's what was key for me. It was a sense of security and also accountability. It was not anything threatening with her accountability. It was like, “If you want to get this to this spot, Jeff, you're going to have to do these things. You're going to have to confront these things and you're going to have to take action.” A meeting with her as often as we did, it felt like a partnership.

Be in the business for the right reasons. Don't let anyone else tell you where you want to go with your business. Click To Tweet

I like that you said that it was someone that was outside of the industry. Did you find a lot of benefit from that, the fact that Sabrina was not a physical therapist herself?

I could state things that were beliefs in our world, Nathan, and somebody who's in the outpatient physical therapy might go into agreement with that but that's where Sabrina could ask like, “Why is that true? What are you basing that on? Where's your factual data?” Ask some of those questions that I accepted as truth. You might probe a little bit and get me thinking, “I don't know. I always believed it to be this way.” I might come to the conclusion that it's not true.

One of the best things that I got from having a coach, and maybe you can speak to this a little bit, Jeff, if it resonates with you, but simply dealing with the interactions with the individuals that I was overseeing and working with, it didn't come natural for me to confront them, to hold them accountable, to somehow encouraged greater productivity, help them through situations that you're dealing with professionally, maybe personally. Utilizing a coach, how do you have that conversation and how do you steer it to the best possible conclusion? That was something that I got from having a coach? Is that something that you also noticed?

Yes, absolutely. She would lead me to come to my own conclusion, the best conclusion and I would feel good about that. She would add that little bit of, “What are you going to do?” “I'm going to have a meeting with that person.” “When are you going to have that meeting?” “I'll have it Wednesday.” “When do you want to report back to me how that meeting went?”

We, as owners, don't usually have people holding us accountable. We’re at the top of the totem pole and so there's no one holding our feet to the fire. It's great to have that.

I want to speak a little bit about that accountability piece too because when we decide, “I'm going to play a bigger game with my business. I want more profit. I want more time freedom. I want to take vacations,” that requires us to be different as the leaders in our business. We have to show up as a different person than the person that we are when we're saying, “I'm going to do it all in my business. I'll wear all these hats.” It's very easy to get excited about an outcome or a vision that you're driving towards, but as soon as the rubber hits the road and you have to show up and be the bigger person, the shoes that you're trying to grow into, the gremlins, the self-talk, the negative self-limiting beliefs pop up.

PTO 30 | Business Coach
Business Coach: It's very easy to get excited about an outcome or a vision that you're driving towards, but as soon as the rubber hits the road, the negative self-limiting beliefs pop up.


I tell clients a lot of times when we first start working together, “I know you're thrilled. This is exciting. We're going to do great things in your business,” and you want to come to our meeting but a month from now, you're going to be like, “I don't want to show up. I'm going to cancel my coaching. I've got a patient. I need to see that patient. That's more important than my coaching session.” The gremlins are coming up because we're on the cusp of doing something great and that's changed. Our gremlins are the enemy of change. They like the status quo. We need that person holding us accountable to our vision of, “You said you want to grow your clinic. You want to grow your profits this way and you want to be able to take those vacations. What are you going to do about it this week?”

What are you willing to do to make sure you reach those goals? The accountability was huge. The guidance and direction that I received were huge. I can attribute a lot of success that we and our clients had through the coaching we received and the consultants that helped train us. Dr. Starling, anything in particular that you felt would be beneficial for most physical therapists? If they're considering consulting, what would be the benefit of coaching to physical therapy clinic owners specifically as you work with a few of them?

Not having to reinvent the wheel. When you work with a coach, whether it's in your industry or outside your industry, someone who has business expertise, they know what works. I work with so many businesses in different industries. I know what works consistently across the industries. It saves so much pain. I had a client that used the phrase pain puddle. He said, “Working with coaches can pull you out of your pain puddle.”

Jeff, any recommendations on your end, some of the benefits that you’ve had from consulting? For those people who might consider a consultant or a coach in the future, what would you say to physical therapy clinic owners?

The best way for me to tell this is in a story. Sabrina, as you can see when you're talking with her, she's a very nice, caring individual. She's small in stature and so forth, but the results that she gets, she is a pit bull when it comes to seeing that you need to fire this person. She wouldn't ever say that. She would never say, “You need to fire that person,” but she would make me see very clearly that, “You're willing to risk everything for this one employee who's not even serving you well. They're taking you for everything.” She would make me see that, “This person is hurting me and the rest of this company,” or when it comes to a decision of increasing profitability and I would feel worried, “Is that being greedy?” and all this.

You got to do what's right by the business before you consider what's right by you. Click To Tweet

She would point out, “Why are you in business? You're in business to build that company and be more profitable.” She was very unrelenting in that way. For me, her as a coach, that passed on right to me, to be that unrelenting, be in it for the right reasons and don't let anyone else tell you where you want to go with your business, mainly your employees who maybe don't have your best interest. They don't have the company's best interest. That's what I see if you’re a physical therapist owning your own business. We're in the business of caring for others. We care for our employees and we definitely care for our patients. We care for the doctors who refer to us. We're always caring for everyone else. It's very hard sometimes for us to take care of ourselves and to take care of our business. It's the last two things will put out there or take care of and that's where I saw Sabrina helped me to keep that focus in.

That's what helped me. I love that you shared that at the very end because that's what one coach helped me and my partner recognize that it wasn't the owner and the business that came last. They actually had to come first. In fact, the business takes priority over the owner. You got to do what's right by the business before you consider what's right by you. If you keep it in that regard, that it's business first followed by owners and then employees, then you'll make the right decision for everybody in that regard. It's the company that's going to run your life and the business than your own. Sabrina, if people wanted to get your book or find you, how would they be able to do that?

The best place to find me and my coaching company is My book is available on Amazon. My book is How to Hire the Best. If you want the free masterclass that goes with the book, you can get that at

Thanks again for joining me on this episode. It's groundbreaking for the Physical Therapy Owners Club podcast to have three people at once. This is awesome. I appreciate, Jeff, you introducing me to Sabrina so that she could share some of her secrets with the world as well.

Thank you.

Thank you, Nathan and Sabrina.

Important Links:

About Jeff McMenamy

PTO 30 | Business CoachJeff McMenamy is the CEO and Owner of Teton Therapy operating four outpatient clinics in Wyoming. They offer both Physical and Occupational Therapy services. The clinics are spread out roughly 4 hours away from each other and see roughly 600 visits per week combined. Jeff is an Occupational Therapist by trade and had to adapt to the culture of Private Practice Physical Therapy. Jeff started into private practice on his own in 1999, then joined up with two physical therapists and eventually became the sole owner of Teton Therapy. Originally from Minnesota, he calls Wyoming home after 22 years. He chose the state for it endless outdoor recreational opportunities and the independent spirit of people. He and his wife Mic have three children and are “Empty Nester’s.” Jeff recently retired from coaching ice hockey after 21 years and is set to spend the winter in a warmer climate managing his company from a distance.

About Dr. Sabrina Starling

PTO 30 | Business Coach Dr. Sabrina Starling is known as The Business Psychologist™ and author of the series, How to Hire the Best, and is the founder of Tap the Potential business consulting. Tap the Potential specializes in transforming small businesses into highly profitable, Great Places to Work, then celebrates by sending business owners on a 4 Week Vacation to celebrate their accomplishment. Dr. Sabrina’s How to Hire the Best series grew from her desire to solve the toughest hiring challenges interfering with her clients’ growth and profitability. What sprang from her experience working with entrepreneurs in rural areas catapulted her into becoming the world’s leading expert in attracting top talent in small businesses, and has earned Tap the Potential the reputation as the go-to resource for entrepreneurs committed to creating Great Places to Work. With her background in psychology, and years of driving profit in small business, Dr. Starling knows what it takes to find, keep and get exceptional performance out of your biggest investment — your team members. Tune in weekly to the Profit by Design Podcast as Dr. Sabrina and her co-host, Mike Bruno, bring you tips, tools, and strategies to grow a sustainably profitable business that allows you to live the lifestyle you desire.

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PTO 19 | PT Ownership


What sets this episode apart from the others is that Dr. William (Bill) Dodson, PT, DSc, DPT, OCS, CHT has gone counter to everything we promote in The Club. While we're constantly looking to promote growth and expansion to obtain more freedom and stability, Bill actually found that contracting and doing less has led to more stability, freedom, and happiness in his life. Thus, he's been uber-productive in his professional life, as you'll hear in the interview. One of the greatest influences in his life is the book, "The 7 Habits of Highly Effective People" by Steven Covey. And during this interview, we talk about how he's used those principles to benefit himself in his practice and, consequently, his personal life. Bill's seen it all and has a ton to share.


Listen to the podcast here:

The 7 Habits of Successful PT Ownership with Dr. Bill Dodson: Stability and Freedom Through Contraction

PTO 19 | PT Ownership
The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change

My guest is Dr. Bill Dodson of West Texas, specifically Midland-Odessa, Texas. I'm excited to bring you Dr. Bill Dodson onto the podcast because Bill has gone counter to everything we promote in the Physical Therapy Owner's Club, and that is to grow and expand in order to obtain stability and freedom. Bill's gone counter to that and has contracted and slowed things down in order to obtain that stability and freedom. One of the things that he's also attributed his success to is the implementation of The 7 Habits of Highly Effective People into his life and practice. If you don't know, The 7 Habits of Highly Effective People is a book written by Stephen Covey. It's a fundamental self-help/business ownership book that you should read. Even if you haven't read it, you've probably heard some of the concepts within it when you talk about paradigm shifts and putting first things first and beginning with the end in mind. A lot of those things come from Stephen Covey's book.

Those seven habits specifically are, number one, be proactive. Number two, begin with the end in mind. Number three, put first things first. Four think win-win in any negotiation or relationship. Number five, seek first to understand then to be understood. Number six, synergize and leverage our differences for good. Number seven, sharpen the saw. Take time out of production to improve your skills. Other things that we also discussed a little bit in the podcast is Bill's usage of the Covey Quadrant, which is the time management and task management system that Covey promotes. Even FDR alluded to such quadrant in his lifetime.

Nonetheless, to tell you a little bit about Bill, he has three clinics in Midland-Odessa and Monahans, Texas. After graduating from the University of Texas at Austin, he starts PT schooling at the University of Texas. He also got a Master’s of Science at Rocky Mountain University, followed by a Doctor of Science in 2007 and a Doctor of PT in 2008. He's a board-certified OPT and a certified hand physical therapist. He's been a PT clinic owner since 1993, a paradigm PT and sports wellness center. He's been an adjunct professor at the University of Texas. He is the host of a weekly radio program on Saturday mornings called Bodytalk on AM 1070 KWEL. If you're driving through West Texas or have access to that somehow, check him out.

Most notably, Bill has also developed a high-end EMR that is specific to physical therapy called Interactive Advanced Medicine. It’s a software program that he's developed over a number of years and has been found to be very efficient. You can also find it at Also to know, Bill is a Rotary Club member and a struggling guitarist of the past 40 years by his own admission. He also loves long walks on the beach, drinks by the poolside, candlelight dinners and long awkward hugs.


On the podcast, we have Bill Dodson, a physical therapist from Odessa, Texas. Bill is a friend of mine, through our interactions with hands-on diagnostics. I've always been intrigued with his story because he's such a productive guy and he's got a tremendous amount of experience in manual therapy. I wanted to have him on the podcast to learn from him and what makes him tick and honestly what makes him so productive. Bill, would you mind letting us know a little bit about your story? What got you into physical therapy, physical therapy ownership and what got you to where you are?

I've been a physical therapist for 27 years. Prior to that, I worked for a land development company. My brother and everybody else wanted me to be an accountant and do all this other stuff. He never felt like I was being led in a different direction. To be honest with it, I prayed really hard and let things happen the way they were supposed to be. It was a good thing. I went to the University of Texas medical branch in Galveston after I got my Biology degree at UT. Then I moved down here to West Texas. If people don't know what West Texas is, it's pretty big. I live in Midland, which is exactly halfway between Fort Worth and El Paso and that's midland. Odessa is twenty miles west and Monahans is 34 miles west of that.

I moved here for one year and one year only. I was never going to stay here for one year longer because I wanted to visit my grandparents. My roots are from Midland. My grandma was born in Midland. Then all of a sudden, I worked at a hospital and I loved it. There were three things that I was never going to do when I was in PT school. First of all, I would never move to West Texas. Number two, I would never work in an outpatient clinic and number three, I was done with school. The first one, yes, I did move to West Texas and I said I was going stay one year and that was it.

Be Proactive. Begin with the end in mind. Put first things first........... (Steven Covey) Click To Tweet

Number two, I would never work in an outpatient clinic. I wanted to stay a couple more years to hang out with my family. I hadn't got to know my grandparents throughout my childhood. I valued their relationship because I never saw a good relationship with my family. It was important for me to pursue that, to view and to hopefully absorb some of the integrity that my grandparents had known with each other, but just in the community and stuff like that. I took a job at an outpatient clinic. The outpatient clinic, they were seeing twenty visits a week. Within three months they were up to 60 visits a week and twice that. We're doing well. I had a good rapport with the doctors at the hospital and so they started sending me patients. Then I became a partner. They asked me to become a partner. I was thinking about going to medical school and God gave me a son, Lee. I decided that that was out of the question. I decided to be a partner at this clinic and then I bought him out and it was the Texas Institute of Sports Medicine, which is very difficult to say even to this day. That changed into something that is still just as difficult, Paradigm Physical Therapy.

Paradigm became a word for that I was trying to teach people around here. It was a new word back. Now, we all know what a paradigm is, it's $0.20. As I was getting out on my own, there were a couple of physicians in Big Spring. They asked me to have a clinic there. There are a couple of physicians in Monahans and asked me to open a clinic there. The great thing about is that I had a pretty good reputation and not a reputation as a therapist, but as somebody who felt service. I'm not trying to pat myself on the back on that. I do believe in stewardship, I do believe in being a servant. Whether I was a bartender working at a TGI Friday's or waiting tables or other places that I've worked in my life, I've always felt like I was a servant.

You feel a purpose. There are some people who may be their ideal scene is to have a physical therapy clinic at some point and be comfortable financially and professionally. You took it a step further. You saw what you were doing as a service to the community and the people that you're with. 

I felt like it. I love the community I live in. People will say, "It's West Texas, what's in West Texas?" The people out here, they bring you in and if you respect them and if you love them, and if you care about them, they're there for you.

You eventually developed into how many clinics and where are you at?

I developed into four clinics. I had 55 employees and I had two hospital clinics, two hospitals in acute care. I also became a partner in that hospital. It was a great opportunity. When the doctors asked me to do it, I was the only non-physician that they asked to be a partner. They wanted me to do the therapy in the hospital because they knew that I was going to do a good job. I would work on Saturdays and Sundays and we clean beds. The thing is even though you have a DPT or DSAT, which DSAT when I came out of the university. I was still doing things that were service and servant-oriented. When you go to the acute care and then go acute care outpatient, typically we'll see those patients and outpatient as well. The continuity of care became top notch. I finished my dissertation at Rocky Mountain and that was ten years ago. I'm going to tell you, I was wiped out.

Mentally, physically or energy? 

Everything, spiritually. I felt like I was null and void. I felt like I would continue to take these punches at work every single day. You have 55 employees, you finish the hardest thing you've ever done in your entire life. You're taking these punches and I said, “It's time for me to revamp.” Maybe we’ll address some of the things that I'm doing because I will kill myself. I went eight years without a day off. I'm not joking. On weekends, I was working in the hospitals because none of my staff wanted to work on the weekends. If I was in town, I was working. Usually, when I

PTO 19 | PT Ownership
The Art Of War

left town it was either for family stuff that needed to be fixed or going off for schooling or education. I needed to adjust things. I made a plan to evolve as a person and de-evolve as a business. I started looking at some things and I'm not saying de-evolve as a business. It’s basically shrinking.

You're weren't going to sacrifice your quality. You said, “Maybe this ship is too big for me.” 

I had hired eight clinicians that were working for me and they were doing a good job, but none of them had the passion I had. You can't motivate with money because I was at a point where the three of them had company cars and they were getting paid well. I was like, "I've got to start doing some of this stuff and breaking it down a little bit." Stephen Covey in The 7 Habits of Highly Effective People, sometimes it was hard in front of your people. I used some of the material that he used along with some from the Art of War and started looking about how to retract a little bit.

Big Spring was 45 miles. I was going there three days a week including Saturdays. I moved into a larger building in Midland and I was growing leaps and bounds there. I let Big Spring go. Then I went and talked to the hospital people. I helped them to recruit and to train their physical therapists to try to meet the standards that the physicians had become used to in the hospitals. I ended my contract there. For once in my life, I only had three clinics, I had four clinicians including myself. We had three clinics and things were like, "This is something I can get used to." To tell you the truth, I felt guilty on Saturdays.

I was going to say, “You’ve got your weekends back." That had to be weird for you. Much of my podcast and so much of my mindset is growth improvement. It’s getting to the next level. You were at a level that many people would be jealous of. Four or five clinics, a couple of contracts, 55 employees. I'm sure financially you were doing fairly well, but you have zero freedom.

At the same time, I realized I was working so hard for my professional employees that I wasn't getting it back. I was like, "Wait a second."

There's probably a limited amount of stability. That's what my podcast is all about, stability and freedom. Financially you're probably doing fine, but if something happened to you, the stability of the business was probably almost done. It's gone and then you have zero freedom whatsoever. A lot of times I'm pushing people, "Get your coaches and get your consultants." The thing I like about talking to you is that you seem to take a little bit of inventory in your life and re-prioritize it and you did it. Used a couple of vehicles to do that, whether it was The 7 Habits of Highly Effective People or the Art of War. To consider, "What do I want and how do I want this to look like?" I don't want to put words in your mouth, but you look back and said, "Maybe I don't want to grow anymore. Maybe I need to be happy at a certain level and focus on quality versus quantity." Quality not only in the business, but quality in life and have more stability and have some freedom so you can enjoy what you built. I hope I'm not far off-base, but that's what it sounds like.

If you respect, love, and care for them, then they will be there for you. Click To Tweet

The 7 Habits of Highly Effective People, there's a way of looking at what's effective and what's efficient. It's important that when you look at effectiveness, you can be so effective that you're not being very efficient. I'm not judging anybody. I've always been in a clinic with open area, very closed doors for lots of reasons. First of all, I'm an extrovert and I liked being around people. I like people to interact with each other, especially if are going through similar situations. Second of all, I like to know exactly what's going on with my patients at all times. I don't think that when they're being behind a door is good. Then also I refused to be a counter. I added up all the years. I've gone to school, it's about sixteen years of college. For me to sit in a room with a patient and count three sets of ten is not what I call effective, efficient. It’s not any of those.

Your people will say, "I love being on that one-on-one with the patient." That's fine. I'm not judging if you want to have that one on one time. I want to be effective and efficient. First of all, I've told some of my patients that we're open these days and these times in the clinics rather than saying, "We're here all day. I like to have more concentrated participation for the patients." In the Monohans clinic, we’re only there two and a half hours, three days a week. We have ten patients come in at that time. I do manual therapy, manipulation, mobilizations. I'm also a certified hand therapist.

Some people might say, "You're running around like a bunch of cattle." I want to let people know that you can run a clinic like that and keep your quality of care at the highest level you would ever think about. I do not need to sit there and count every repetition for a patient. I do need to watch and make sure that they're doing it the right way. The big battle is as a group therapy or one-on-one. I don't care about that. I always take the safest route. It always works well. What I'm saying is I can be effective with five patients in an hour and be efficient with them at the same time. It's not going home and say, "Did I just run a bunch of people through my clinic or did I help somebody?"

PTO 19 | PT Ownership
PT Ownership: The more force you can provide in the lesser amount of time, the greater the impact and impulse you have under your care.


It was funny because I was talking to Bob Donatelli and his crew. They were talking about the new way of running your clinic where it's open. The therapist is in a position of control. Then you have people in areas and then you had PTAs or other therapists more as a team rather than individuals doing one thing one day and one thing the next day. That's how we run. That's our effectiveness and our efficiency coming together to see people and at the same time, not running them through a little cow guard and making them feel like that they're just a piece of meat.

I love the way you do things simply because you've focused on what you're the expert at and done away with the stuff that maybe a non-skilled person could do. If you look at some of our industry leaders in treatment, I'm thinking specifically about the Australian concept, they don't see patients for an hour. They don't even see them for 45 minutes. They get them in, they do their manual techniques, they ensure that they're staying up maybe with a stretch or two, exercise at home and that's it, and they move them along. They're effective, they get straight to the point, and then they move them along. You've focused and not only scaled back in your business. I don't know if you were always doing that, but at this point, you’ve also scaled back your care as well to be both efficient and effective. 

We've always had a strong exercise program here. I've always worked on corrective exercises. Those are different than shorter squats, long squats, standing hand crows, mini squats. There are certain corrective exercises through the SFMA programs and stuff like that we use. The time is still there for the patient. Impulse is force divided by time. If the impulse is effective and very forthright, that means if I'm doing dry needling on somebody or manual therapy from doing the Graston Technique, I want to be focused with that patient when I'm doing that. If I'm building a splint for somebody, I want to make sure that it's absolutely the perfect splint for their hand and for their upper extremity. It does exactly what they do. I try to explain to my staff, in my time with that patient, is there a high impulse that's forced divided by time? When I talk about force, I’m talking about quality, a high quality of care. Is that a good time? Of course, people are going, "What's this impulse thing?"

The way you describe it is it makes a huge impact because the more force you can provide in the lesser amount of time, the greater the impact, the greater the impulse you have under your care.

The happier patient you have because they're not there spinning their wheels. That has helped us to become a stronger clinic too because I had thought that we were going to be slowing down with the new medical system that was going up. That's one of the reasons why I joined HODS. I lost my very best friend who was our main referral to pulmonary embolisms. Not only was he my best friend, he was a mentor to me for so many years. Then he became my colleague. He was an orthopedic surgeon, but then he became my colleague. We had an incredible relationship. When he passed away, I lost my friend first of all, and I lost a large referral source. Then the other referral source was another good friend of mine who got upset with Obamacare and decided to go to sell testosterone in Texas.

He went from doing twenty total knee replacements in a week to doing testosterone. He's making twice as much money and he didn't have the liabilities. All the hospitals around here started to gobble up all the other orthopedics and all the others. I thought, "What am I going to do? What has happened?" Because I keep true to my integrity and my values and I keep that and I keep my compass, I keep it facing north. I'm a tough employer. I'm not going to lie. I'm pretty tough. I don't mess around with a bunch of small stuff. If you come in here and you work for the patient, that's what I need. I don't need a lot of other stuff happening. I don't think anybody likes that, to have drama and stuff like that.

I made a plan to evolve as a person and de-evolve as a business. Click To Tweet

I tell my employees, my coworkers, “Here's we’re at and here's where we're going and this is our mission statement. Our mission statement is to provide the very best possible care to the individuals in this area and to continue to strive to be the very best clinic anywhere. If you can help me with that, that's great. If not, we're going to have some problems.” I thought my clinics were going to be dissipated. We kept pushing. I started going to the partner HODS. That was probably one of the better things I've ever done too. I don't know how you feel about that. It absolutely turned me onto a lot of things and then all of a sudden, these doctors around here started going, "Dodson is doing some stuff out there that nobody else has even thought about."

I'm looking over The 7 Habits of Highly Effective People and I have them listed out in front of me. That story alone or the way you interact with your coworkers, it checks off a few boxes. You're showing them the end in mind. You're beginning that relationship at the very beginning with the end in mind. You're putting first things first, which is the patient care and it's obvious that you're completely and totally committed to that because of your inner purpose for service that you can't keep it within yourself. It's going to expand out into your company as well. You're also synergizing you say, "Put the other stuff to the side. We can have differences, but how can we come together to leverage our differences for good?" It's cool that you've taken some of those concepts and woven it into how you interact with your coworkers and how you lead your clinic.

You've got to categorize your priorities too. What's in there? What's urgent? There's another quadrant that people get stuck in. What's important? What's urgent? People think that the important stuff is stuff that you have to do. Nothing is that important stuff that you have to do now and Steven Covey put that as top priority category. Then you put what's not urgent, but important. That’s stuff that you need to focus on. You focus on that.

You want to live in that one right there. You want to live in the important but not urgent stuff.

Important but not urgent, that's where you need to focus on. Because eventually if you don't focus on that, then everything is going to be important and urgent. You're going to go crazy. Then that third area, which is not important but urgent, that's the stuff you delegate to others.

That's where we get stuck. Just look at your email inbox. There's nothing but a bunch of urgent but not important tasks in there. If you live in that quadrant where you're dealing with all the urgent stuff and usually it's other people's urgent stuff, it's not your urgent stuff. You might be efficient in getting a lot of those emails done, but you're not being effective as a leader.

That's self-enslavement and I realized that. The fourth is not urgent and not important. If you ever want to be successful in anything, you stay out of that fourth one. That's time wasting. Surfing the internet, Facebook. I probably have spent one hour on Facebook this entire year.

I spend too much time on social media at times when I want to numb my brain out. I'm sitting there thinking, “I could be doing much more important things.” 

What I do is I'll look at an article and I'll send it to our person that does our Facebook and say, "Why don't you post this for me?" I'm rumbling through some stuff. I also have a radio show. From 2:00 to 3:00 on KWELA 1070, it’s the time for me and the guy that owns the place. He's my producer and he let the calls come in. I've been doing it for ten years. It's a cheap advertisement. It probably saved me psychologically thousands of dollars because I get to talk about what I want to talk about. At the same time, I get to educate people in a way where they can understand. I bring out my West Odessa accent. You talk to them and you make them laugh a little bit and you educate a little bit. Hopefully, people start going, " This is not what it is. I'm not going to feel intimidated every time I go into my doctor's office. I'm going to have five questions because Dr. Bill told me that five questions. I'm also going to sit in the chair right next to the door.” There's a reason why. That's the escape for the physician to get out of there.

You want to block it if you’ve got to.

You can be so effective that you’re not being very efficient. Click To Tweet

"I've got questions for you, sir or madam." There are lots of things we talk about. We talk about nutrition, we talk about exercise. We talk about the myths of food and the myths of exercise so it's a good process.

What a great way to promote not on your clinic, but I see it as an extension of your purpose and that is to serve the community. You're doing it over a broader network, but people call in one-to-one. You're able to share that experience with them one-to-one and expand your reach and that's awesome. 

That's where Stephen Covey said, "First of all, what are your one-on-one influences?” Your patients and your employees, and that's good. Then you've got your local community and you had your greater community. I used to be the strength and conditioning coach for the Jackalopes. A Jackalope is a nonexistent animal, it’s a cross between a Jackrabbit and an antelope. They had a fantastic hockey team out here. They were all in the IHL, which is below the NHL for many years. I also was a strength and conditioning coach for the Arena football teams. Those are things that didn't make me a cent as far as money. I'm going to tell you that the reaching out there, being with the kids, being with a program that had high expectations and high value.

I love being out in front of people. I'm a shy guy, I get it. I have a hard time being in front of people. It was time to get out there and that's called increasing your sphere of influence. People are calling me saying, "Can you come to speak at this place? Can you help?" Usually, the answer is yes. That's another thing. The inability to say no is bad, but the inability to say yes is even worse. If somebody is coming to you and saying, "Can you come to talk to our students?" I look at my schedule. "I've got 30 minutes." I have also found out that I had a hard time saying no. I look at the value of the thing, whatever it is on the clinic, myself, our staff, the value towards the community. Some people say, "I've got this hot rod, I want you to put your sticker on it." You're going to be out there for five seconds and you want a sticker on your car. The chances of you making it down that quarter mile are slim and none. I don't put a big value on that.

PTO 19 | PT Ownership
PT Ownership: It was the most difficult lesson to learn how to say “no” to people.


It goes even greater. You can correct me if I'm wrong, maybe there was an inability for you to say no back in the day when you were working seven days a week for eight years straight. At some point, you had to say no to something that was maybe something you have to learn the hard way.

It was the most difficult lesson to learn how to say no to people. The problem was I was saying no to my own son. I was saying no to myself, I'm saying no to relationships that should have been important. I made some big mistakes. I'm 54 and I've never been married. I'm probably dumping a little too much out there, but you can get yourself into some trouble internally, where you start losing your flame for spirituality and for a family because you thrive on helping people. I felt like it was Robin Williams. He was addicted to people laughing. He had to be around everybody, he had to be the center. He had to make people laugh. My thing was I want to help people. I want to make people feel great. I want to do things for them. I want to get them back on their feet. I also had another incident. It was my main competitor around here. He said he'd have my license in a year if I didn't close my shop down. There are lots of incentives. What I lost, I did lose some things during that time.

Going back to a couple of the other habits that Stephen Covey lists out, what do you do to put first things first and also sharpen the saw? What do you do so you don't fall back into maybe some of those bad habits that you had over those eight years?

I have a software program and that sounds like that made it worse, but it did well. I developed a software program that my documentation time in the day is one-tenth of what it should be if I were using any other software program or writing stuff down. It's called Interactive Advanced Medicine, iAMPT. It has turned us into an efficient and effective clinic that I've never thought available. My documentation time for an evaluation literally is how fast and how clearly I can speak into the assessment at the end of the time I'm with the patient.

You’ve got to categorize your priorities too. Click To Tweet

We're looking at maybe a minute to a minute and a half to complete my evaluations. The note is about ten seconds. The reason why I did it is it's not like any other program. By the way, I started developing this in 1993. I had my own software program in 1993. It just evolved. My premise behind this entire software program is, is it effective? Is it efficient? If it's both of these then it goes in. If it's not, it doesn't go in. It's got to be easy to use. It can't be these big timetables and buttons where you're going all over the place. Whereas if you see the icon, that means you need to use that icon. It saved me so much time that I could go to HODS. I'm filling back at my time. My son, he's 24 years old. I don't see him as much as I'd like to. He lives on the other side of Texas, not like Alaska.

That again has taken given you the opportunity to take time away to develop the relationships that are going back to the sharpen the saw concept. What gives us energy and life and purpose is the ability to connect to those people that are most important.

Sharpening the saw is HODS. The people at HODS had helped me become the clinician that I will never in my wildest dreams thought I could become. Even though I'm a certified hand therapist and a wound specialist, I have those credentials and those are fine, they helped me to not just use those credentials, but to delve deep inside of what's going on with the carpal tunnel syndrome. Is it a carpal tunnel syndrome? What is it? How can you effectively help the patient make a decision? You talk about effective versus efficient. Since I treat the patient, "You don't have a surgical problem. You have carpal tunnel problem. Let's go ahead and work with a carpal tunnel problem." Then that's efficient right there. Instead of spending $20,000 to go into treatment, find out they don't have a surgical problem. It gets done right then and there.

We can take on the opportunity as a profession to become greater diagnosticians and not just go off of special tests and best guesses. If we can diagnose what's going on and patients from a neuromuscular perspective and from a musculoskeletal perspective if you're going to use a diagnostic ultrasound, that speaks to your point. We become very effective because we know what we're dealing with in actuality and we're not just guessing. We can have pictures and the information that we need to provide an accurate and effective plan of care. 

It's that impulse thing again, how much impact can you get in the time? Dr. Costopoulos, Dr. Kostas, they are absolutely the highest quality people and they have stimulated me so much to become better. I know they have you too. I know this isn't about them, but I'm letting you know that's where I'm sharpening the blade. It is helping out. Our clinics even have a better name than they'd had before.

PTO 19 | PT Ownership
PT Ownership: If we experience some measure of success, we want to change that into a measure of significance and influence in the world.


You've also offered consulting, you've offered people to come and check out your model. You have also offered to show how your self-developed EMR works. Tell me a little bit about that. How can people get in touch with you and how can you help people who are maybe looking for a little bit of support?

I've helped several clinics who are worried they're starting off or struggling. They didn't have the right model available for them. It wasn't working. While I was going through a Rocky Mountain University, I did a couple of consultations with some other therapist when I was there. The consultation has two parts. One is we sit down on the phone we ask some very specific questions, very similar to what we've been talking about. “What do you need? What do you want to do? How aggressive do you want to be? What are your weaknesses?” I'm talking about the true weaknesses, not donuts. I'm talking about hardcore weaknesses. Is procrastination your weakness? Because it's my weakness. My devil is procrastination.

Take on the opportunity as a profession to become greater diagnosticians and not just go off to do special tests and best guesses. Click To Tweet

That’s what I love about our software program. I talk to them about our software program and I'm like, "I'm going to tell you, none of your therapists should be going home late at night, nurses and therapists should not be going home with your documentation today. We retrain your therapists how to do documentation, how to stop procrastinating, how to do it on the fly versus going back to the desk. If we can stop doing that, then we can make them more effective. Then we decide whether, "Do you want to come to my clinic first or do I go to your clinic?" If they're like, "I need some help." I’d go to their clinic with two of my employees and an admin. Then I have my chief technician to come with me and I sit with the therapists on a Saturday and a Sunday.

I talked to them about what they do know what they don't know. I'm very respectful. I'm not the smartest guy in the world. In fact, I'm willing to guess that anytime I'm the dumbest guy in the room. I approach it in that fashion and not burning people saying, "Here's the deal pickle, you're spending too much time with your patient counting for them. You're a professional. When was the last time you saw a physician come in and say, "I'm going to take your blood pressure?" When was the last time you saw a physician come in and say, "I'm going to explain to you what your medications are all about?"

You've got to get lean and mean. I teach them how to get lean and mean. Yes, they use my software program and yes, they love it. It is like nothing else out there. Then they come to our clinic first, then I have them bring, two or three of their staff. We break things down to the absolute minimum, "Why are you doing things this way?" Just like we did in PT school or PTA, we learned, "Why are we doing it this way?" Do I need to break that problem down and dissect it? We find out what's good, what's bad, and then we rebuild it and see if it's a better model. Of course, the software program that we have, it does the outcomes, it does billing, and it does the scheduling. It is a Porsche, high quality and it's very fast. That's what I do on the side. I'm transitioning. I've been a PT for 27 years. I've got to transition to something else, just like you. I'm transitioning from maybe stepping away from patient care to let's see who I can help run their clinics or who I can help teach. I would definitely love to teach later on in life and help maybe change some of the models of teaching that we have as far as physical therapy schools because some of the models are not that good.

It seems like your purpose is the same, but your sphere of influences is possibly enlarging and that you want to go from maybe some success to greater significance. A lot of us see that as we get a little bit older. If we experienced some measure of success, we want to change that into a measure of significance and influence on the world. 

Strive for quality not only in business but the quality in life and to have more stability and freedom. Click To Tweet

I was talking to the guy that's helping me with my marketing. He goes, "What's your goal?" I said, "I want to be the Tony Robbins of physical therapy." I want to be the guy that gets in your face and say, "You're a fantastic person. You have great ideas. Everything is good, but let's find out what your demons are. What are your demons are with respect to your business? Are you not taking good care of your equipment? Are you not taking care of your employees? Are you not taking care of yourself?" All those things and looking deep down into the business practice rather than saying, "You're not making enough money."

That's awesome and that's a great thing to aspire to. We could always use some more inspiration and leadership in the profession, that's for sure. Is there anything else you want to add? You've shared so much wonderful information. Anything else you want to share outside of your personal contact information and whatnot? 

You got to get lean and mean. Click To Tweet

I love physical therapy. I absolutely love it more I love it more than the first day that I started it. I wake up in the morning and I think about things. I think about people and with the ability to do diagnostics, I'm going, "This is a powerful field." To tell you the truth, it's the most powerful medical field by far. The rest of the physicians or whomever, they don't get the stuff we get. I tell this to the students that come in and I say, "If you're going to go into this field, I want you to become the person that I want treating me later on in life. If you're not going to be that person, then I don't want you to be a part of my field." They're like, "What?" You might not be in this field for the right reasons. If you're not in for the right reasons, then do our profession a favor and get the heck out. That's what I love about you, Nathan. You are totally are passionate about our field and I love the fact that you do in this show and you're doing this gig and you're helping people out.

If you want to get in touch with me, or you can get me at and I'd be more than happy to talk to anybody about anything. Through the software program, I've helped people there, just helping them out, answering some questions. There are huge pieces of information that are making them so successful. Many I haven't charged because they need some help. My passion is physical therapy and it's helping people out and that's what drives me.

I hope people do reach out to you because you have a ton to share and wisdom. All this stuff that you've been through and learned and your ability to make an impact and be effective and efficient, if you don't pass it along, then it's a disservice to the profession. I hope you influence more and more people as you go. 

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About Dr. William (Bill) Dodson

PTO 19 | PT Ownership

Dr. William (Bill) Dodson is a physical therapist in "West Texas", the Midland, Odessa, and Monahans, Texas area. After completing a Biology degree at the University of Texas at Austin in 1989, he attended Physical Therapy school at the University of Texas Medical Branch in Galveston, Texas and graduated in 1991. While attending Rocky Mountain University of Health Professions, he earned a Master of Science in Physical Therapy (1999), Doctor of Science in Orthopedic Physical Therapy in 2007, and transitional Doctor of Physical Therapy (2008). Dr. Dodson became a Board Certified Orthopaedic Physical Therapist in 1998 and a Certified Hand Therapist in 2001.

Two years after graduating from physical therapy school, Dr. Dodson opened Paradigm Physical Therapy and Sports/Wellness Center, covering much of West Texas. He has also had numerous hospital contracts during this time. To date, he still owns and is the chief therapist for the three clinics in Midland, Odessa, and Monahans, Texas. Over the past ten years, he has taught physical therapists Dry Needling techniques in the US and Canada. As an adjunct professor, he taught Analysis of Human Movement at the University of Texas of the Permian Basin for several years. Dr. Dodson has also worked with local pro and semi-pro hockey and arena football franchises. He is also the host of “Body Talk”, a medical, health and fitness radio program on AM 1070 KWEL.

During his time as a physical therapist, Dr. Dodson developed the high-end physical therapy electronic medical record and business management system, Interactive Advanced Medicine (iAM-PT). He also has three patents dealing with objectively measuring pain, using computer-assisted measurements.

Outside of the physical therapy domain, Dr. Dodson is a member of the Rotary Club and has been an ever-struggling guitarist for over 40 years.

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