E440 | Chad Burnham Interview

 

Today's episode features Mastermind Member, Chad Burnham! Chad has owned ProForm Physical Therapy located in Salisbury, MA since 2016! We discuss his practice, how things are going for him, and much more! Enjoy!

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Podcast Transcript

 Danny: [00:00:00] So one of the worst parts, in my opinion, of running a practice myself, was trying to figure out super bills and trying to keep track of super bills as well. Here's what I would get. Nobody would tell me they won a super bill and then six months later I'd get an email letting me know they needed six super bills so they could submit for outer network reimbursement, and I had to go back in and try to figure out what I saw him for and put everything together correctly for them.

This is. A company like PT Everywhere solves this problem and creates a ton of time freedom. For me, all of the super bills for anybody that we see within this platform with our local practice is housed within their member portal. So they actually can access it themself. We can see it, we can print it off with one click, we can actually track all their payments, their memberships, their packages that they have, and send them out anything they need from a documentation standpoint.

All in one simple, easy to track place. This saves a ton of time and it's really made it seamless for us to be able to have better communication on the reimbursement side with our clients that are requesting it. So if you are in practice for yourself, you're thinking about going into a cash rack, it's, I highly recommend heading over to pt everywhere.com, [00:01:00] checking out what they got going on, because it has helped us a ton.

We use it personally, and I highly recommend that. Use it within your practice. So here's the question. How do physical therapists like us who don't wanna see 30 patients a day, who don't wanna work home health and have real student loans create a career and life for ourselves that we've always dreamed about?

This is the question, and this podcast is the answer. My name's Danny Matte, and welcome to the PT Entrepreneur Podcast.

All right, what's up guys? PT Entrepreneurs Facebook Group and the PT Entrepreneurs podcast. I'm Doc Danny. I got Mr. Chad Burnham on here with me today, man, one of my favorite mastermind members. Definitely with the coolest haircut and the the best biceps. Just got a chance to hang out with him and your wife, man.

So excited. I finally got to meet your wife, Katie. She was super cool and and she got. See what our community's all [00:02:00] about. I'm sure she's what are you doing with these people? Oh, yeah. In Charleston or whatever. But I'm more than excited to get you on the podcast so we can share your story.

And number one, man, I know how busy you are. Thank you so much for taking some time out of the middle of your day to, to do this.

Chad: No, it's great cuz I have Mondays off now I have all the time in the world now, Danny. Thanks to you guys oh, it's perfect.

Danny: It's perfect. Yeah. And if you guys are watching this video, like Chad, if go check out his you guys did an M t V cribs video of your space, right?

Yeah.

Chad: Yeah, we did. It was MTV Cribs edition. Yeah. Yeah. It was like, and

Danny: it's awesome. Yeah. Cause you got you got the cinder block wall back there. You got the big ass fan. Everybody's some rigs Yeah. To do a little rotational strength work right now. I love it. Yep. It's,

Chad: It's actually our lunch break.

So we close down from 12 to two every day and everybody gets their workout in you've got it. Perfect

Danny: timing. I remember you telling me that. And this is a perfect segue into just like culture, right? Like you guys the kind of dude, health and wellness is just a part of what you guys do, right?

So you actually open up your schedule the middle of the day. Y'all lot people do this for documentation. Yeah. I worked [00:03:00] at a clinic where they're like, Hey, you have an hour and a half middle of the day. But really what they were saying was you have 30 notes to write. So yeah, do half of them over lunch, right?

So you're not here too late. Or you guys are like, nah dude, work out. I think that's awesome. Yep.

Chad: That's what we do. And the patients love it too. They love that we're practicing what we preach and they wanna know what the workout of the day is or what we brought to lunch, cuz we'll just eat it right out in front of 'em.

Cause we eat all day too,

Danny: Yeah. Yeah, that's huge. And for sure if you guys are interested in just seeing what a unique space looks like, go check. Chad's website. It's Proform. Is it P tma, right?

Chad: Correct. Yeah. Proform Ptma. And that's our Instagram too. We

Danny: have a lot of, so go check it out.

You can see what a space looks like. And they do some really cool plays on like movies with their marketing. You guys do Footloose and something else?

Chad: Yeah. That's on movie Monday. It's. And we haven't done 'em in a little bit, only because we've been so busy. But yeah, we take a little scene from a movie and then we put our own little twist on it, make it functional.

Oh yeah, we did put loose. I finished with Moana. That one was my favorite. That was a good one. Yeah, dude, my

Danny: daughter was in a Moana phase for about. [00:04:00] I wanna say like a solid 18 months. She had a, oh yeah she had a necklace with the heart of TFiT or whatever it's called. Tfe. Oh yeah. Graffiti Heart of the Graffiti.

Yeah. Yeah. Man, you would hit the button and then it would start singing and yes, it would be all day out here. I would hear whatever song it was, but that's a great movie. That's definitely one of my favorite movies. A good. But alright dude, let's get into it. So tell me this, first of all what's your background, man?

How'd you get into physical therapy? Like what, what brought you into the career to begin with?

Chad: Yeah, so I'm not one of those stories where I got injured playing a sport or anything like that. Had physical therapy in high school and it was actually my brother that first got me into it and obvi was his fault.

But it was he was involved in a snowmobile accident about 20 years ago, which ended up resulting in him having a below knee education on the right side. So he he had to go to physical therapy every day after that, and I had just got my license, so I was the guy that took him to. Every day. So I would go through the exercises with him too as well.

And he's the one that kind of got me into that. And that's, that was my first introduction to [00:05:00] physical therapy. And from there it just kind. It blossomed, once I went up to school and did some internships and, saw everything else that was involved with it, I was like, dude, this is definitely what I want to do.

Yeah. I contemplated pharmacology, but then I did an internship there and that was, I can't count pills all day, so that, that killed me. I need to be active, dude, that was,

Danny: I hear you. I did an internship. I was in high. And I worked, I was getting hours like volunteer hours from my high school.

I did part of my time at a pharmacy and the other part was at a physical therapy clinic. And I would go to the pharmacy and they all seemed like they were slowly dying. Yep. They just, they, it was the most boring place I've ever been in my life. And then I went to the PT clinic and they're like eating cake with patients and stuff, and they're playing music and they're like, whoa, this is.

This is way better over here.

Chad: Yeah. Pretty much a similar experience. Yeah. They pretty much told me not to do pharmacy. Don't do that. I said, okay. Yeah. This is what you'll be doing

Danny: for the rest of your life. I can't imagine you as a pharmacist, man. I think you picked the right career. Yeah, totally. No, that's crazy.

So your brother had a snowmobile accident. You right. You took him there, you get, you got [00:06:00] exposed to, all that stuff. And from. You decide, all right, cool. I'm gonna, this is the career that I want, but like, how long did you work as a clinician before you went into starting your own practice?

Chad: Yeah, so when I got outta school I had great mentors, which was awesome. And I started off at about, Four years or four and a half years at a clinic down in Rhode Island. Cause that's where I went to school. We stayed down there for a little while. Once my wife and I had our first daughter, then we moved back up to Massachusetts, New Hampshire.

And I ended up getting another job and another outpatient, they, these were all outpatient private practices. So that was a an environment that I was familiar with. So I stuck there. I like the family owned stuff, so I stuck there as. Worked there for about another three and a half years, and I just felt this, I always had this need that I wanted to, open up my own spot.

And it was mainly because I everybody says this, but they feel like they're not getting appreciated. They don't feel like they're getting, the appreciation they deserve for the amount of work that they're putting in to build somebody else's business, which is, I'm fine with that.

As long as I was getting the appreciation, I wasn't getting that on my end, unfortunately. So I just found out I could do it better and.[00:07:00] Tested the waters a little bit. I actually wound up going into an office where I had a friend that I went to school with. He was a chiropractor, so we went off the chiropractor school.

I went off to PT school. We met back together, and then after we met together, I said, Hey man I'm looking to open up a spot in your area. What do you think? I was like, I just wanted him to tell me how the market was, cause I wasn't really sure. And he said, dude, now that you say that, he's I got a spot in the back.

You could probably work for you. It was like 600 square feet. It was enough for what I needed, and I went there and I was like, yeah, this could definitely work. So we ended up outgrowing that place cuz we, we knocked down a few walls outgrew it to the point where I was like, all right, we need a bigger space.

And then from there we opened up this spot here about a year and a half. It was more or less like trying to give people what they weren't getting, and what I wanted to give them. And I couldn't give them because I didn't have the time because I was so in this huge insurance based model.

Yeah. Which, we st that's where we started and, we're full cash now, but I would say that was like the most aggravating part of the whole entire thing is to have to, try to fit [00:08:00] as many patients in as you can. You're like, why did I even do this? Why did I even go to school?

Danny: Yeah. Yeah. That sucks. You feel like a waiter, right? Totally. I want to backtrack for a second cuz you said, you. You just felt like you didn't ha, weren't, didn't see much appreciation for what you're doing for the practice. What, is there anything that the people you worked with that they could have done that would've put you in place?

Cause I see somebody like you and I'm like, dude, if you can harness this it could be massively beneficial for any business, right? If somebody could take. Your drive and your ability to inspire the people and you could somehow get that to work within somebody else's business.

What would that have looked like, if anything? Or would you have always kinda ultimately ended up doing your own thing? I

Chad: probably would've done it anyways, but maybe it would've taken me longer. I know everybody always says it's like it's never the right time, but I don't think it's ever the right time.

I think you just have to just, just decide that you're gonna do it. And it's funny the story behind that is I signed my. For the new spot. And literally two weeks later we found out we were having twins. Wow. And I was like, shit. So [00:09:00] my wife looked at me, she's what are you gonna do? I was like, I don't know.

I think we're just gonna do it. So yeah, that was the scariest part of the whole entire thing, to be quite honest with you. But in that last place that I was working at, I was always at, because we were working in a gym, so the PT clinic was in a gym. And I worked very closely with the trainers.

So I would see the trainers all the time. I would give them, pro bono treatments, I develop re relationships that way. I'd go in on their trainer's meetings once a week, and all of a sudden they just started pulling me outta the trainer's meetings and they were like, no, don't waste your time there.

It's not worth it. I'm like, dude, but it is worth it. Look at all the referrals that we're getting. Yeah. And they just couldn't see that. They couldn't see it. And I built so much time building up that part of the business for them, and it went nowhere. So I was like, all right I can see the writing on the wall here.

So that was me.

Danny: Yeah. Okay. 600 square foot space. The back of your buddy's chiropractic clinic. Yep. How long were you there and then what was the next step for you guys?

Chad: Yeah, we were there for just about three and a half years. Yeah, just about three and a half years. It went from about 600 square feet.

I think we finished at about like 1300 [00:10:00] square feet after we knocked down some walls. We had a. We had a common area in the front where we shared a front desk. So it would be the chiropractor was on one side and the PT was on the other side. And he was like very crucial for me in the beginning with building up some of my clientele in the beginning cuz he would actually refer people right over to us, that he thought could benefit from physical therapy services.

So he was a very good advocate for us in the beginning. Absolutely. And we're still like right next door. So the story with that is, is like once we outgrew there, we were looking for a place to. And the guy that owned the whole building actually had this like storage building out in the back.

It's his own building. It was like a shell. And he would store like all of his stuff in there for the plaza. So it was like a plow truck. He had a pontoon boat in there. It was, it is a huge spot. It just needed to be finished. And when he was like, Hey, you should check out that place, I was like, yeah, I should check out that place.

So I checked it out and I'm like, man, this is actually like really huge. I don't know if I can use all this. And then once we actually started building it, I was like, wow, this place is actually not as big as I thought it was gonna be. This so happens. But we're still, in the same plaza, but we're just like 500 feet over, once we grew, outgrew that place, it was [00:11:00] time. And we al we ultimately always wanted to go to this performance based model anyways. And we were at, we just, we couldn't do that, yeah.

Danny: What size is your facility right now? Like how many square feet is.

Chad: 3,400 square feet.

Danny: Yeah.

Cool. Yeah. And you know it, yeah, it looks really cool. It looks like you guys have Yeah, like a mezzanine level. Yep. A gym area. So where do you, how is this set up? Where are the treatment offices, and how big is the the actual gym area?

Chad: Yeah, so the treatment op, okay.

I'll see if I can move this, the treatment. Rooms are actually like right underneath me. That's the infamous basketball by the basketball call. I was gonna say. Yeah. Yeah. That's actually awesome. Anybody that's thinking about getting one of those, they should. Sure. So this is the whole downstairs. So we got our treatment tables over there, and then over where those doors are.

That's where our waiting room is, so you can't actually see inside the gym itself. Gotcha. And then we have over here, we just have more. Up on, on the top. On the top mezzanine area. Yeah. Cool. So it's it's pretty awesome. It fits all of our needs very nicely.

Danny: Yeah, no I think that's, I don't know [00:12:00] for you, obviously I think you're like one of the most branded people I've ever met and shout out, hey, that, that water a shaker bottle you got us is awesome.

What was the name of that again? Maybe you can stop ice. Ice shaker.

Chad: Yeah. Ice shaker. Yeah. They're awesome dude. They, it's like a blender bottle and a Yeti had a baby. That's what I always say. Yeah. It's awesome. So you can shake your protein in there and it keeps stuff cold and it keeps stuff warm.

So it's,

Danny: Yeah. It's the best part about it is that you don't have that agitator bouncing around in there. Yes. Cause it's so annoying. It's Sits at the top, but but yeah, like you, you gotta, you got those for our whole team. We really appreciate that it was branded with our logo on it and stuff like that.

How much did you enjoy the creative process of building out your space of what it was gonna look like and all

Chad: that? Yeah. Honestly it was, so we had an architect that did like the foundation of it, and from there it was actually, my wife was involved with a lot of it because I can't see paint colors.

I've just like the one thing I can't do is Different undertone from another undertone. I don't know why I just can't do it. But in terms of building out the space, it was super fun. We were like, we're gonna put this rack here, we're gonna put this over [00:13:00] here. The upstairs is gonna be that.

And honestly, we changed it three or four times because the hardest part is trying to figure out how you can maximize your space. And I was like, oh, we could put an office over here, but do we really need an office? We probably don't. We could use, that to maximize a space and have. Space to work with patients or clients or whatever it may be.

So we had this overall vision that we wanted to incorporate more training as well as the physical therapy. So I was like, man, we need more space. Actually this whole top mezzanine was supposed to be offices. I don't even know why I thought that was gonna be a good idea. And I think it was mainly because of the square footage of the building.

Cuz they tried to, Based on the square footage of the building it's technically considered a second floor. It's not really considered a mezzanine just because it's more than a quarter of the square footage of the total size of the building. But I said, you know what? Let's just knock all those walls down and let's just make it open, cuz we'll use it for training.

And that's what we do now. So we put all turf upstairs. We're still getting stuff like we, that's the fun part about it. We're like, what else can we use? We don't really need anything. But what would be cool to have

Danny: what I, yeah, toys, man. You just made your own gym basically, which is awesome.

And I think for what you guys are doing in the direction that you're going, like it's really [00:14:00] this, it fits what you're performance based model is that, you guys do. And I'm interested kind of going back to. You started the insurance base side of things.

What did that look like? What was that transition like as you guys came into this space and really what are the things that were good about that model and what are the things that were obviously frustrating enough that kind of pushed you away from that model?

Yeah.

Chad: So I will say that the insurance-based model is definitely an easier model to work with. You definitely have to work harder in a cash-based model and it's for a good reason, you can spend more time with your patients and everything else, but in terms of getting those patients to walk through your door, it's not as easy.

We would get scripts from patients, we get people calling us all the time from their doctors. And now it's not so much happening like that, we have to do more work. The front end to make that happen. That's the downside. The other downside is that the reimbursement was really bad.

They would retract you, maybe not pay you all depending on the insurance company. I actually just got a retraction just two weeks ago. From a motor vehicle accident. So for all of you that are thinking about going out of [00:15:00] insurance, it doesn't even end when you go out of network, like it's still coming.

So this is a case where a woman had a motor vehicle. And she didn't tell us that it was a motor vehicle accident. So we continued a whole full plan of care. This was two years ago, mine, this is 2019. And just got a notice today that saying that they're retracting all those payments. Now they can't take it from me because they're not billing me.

They're not, I don't get any eras from them anymore. So I gotta send them a check for, whatever it is. But it never ends. So then now I have to call the patient and tell the patient, Hey, listen, guess what? You're, you said you have, were involved in a motor vehicle. But you didn't tell us.

Yeah. So how's that gonna work? Huh? It's two years down the road, so we can't file any claims now and nor could we any anyways yeah, so it never goes away. So those are always the things that insurance was like putting on us. It was always like, trying to not pay you for certain services or they would change their modifiers so that, if they tried to make it tough so that you couldn't build certain codes.

They would change that year to year, and you had to be up with that. [00:16:00] If not, then you had to face not getting paid on certain charges, and then have to, re resubmit them and then wait another 30 to 60 days and hopefully you get paid. And that was just the frustrating part.

Now the fun part is like, The patient's paying for your service at the time of service and it's, that's what it is. You not have to wait for 30 to 60 days to see if it actually works, cuz you know it works. So it's, that's the most frustrat that's what drew us. That's basically what drove us out mainly and the fact that we couldn't spend the time, like they just keep on decreasing our reimbursement rates.

But there's nothing else that, that we're getting as a bonus, as a provider to provide that insurance for these patients.

Danny: It's. What was the average what was the average per visit you guys were actually gonna, you were getting back? From insurance, typically,

Chad: so right before I joined your mastermind, our average reimbursement rate was $76 per patient.

76, okay. And some insurance companies would reimburse you a flat. So it would be, I think United was like $70. No matter if you spent 20 minutes, 30 minutes, or 60 minutes with [00:17:00] them, they would pay you $70. And that's where we lost on those insurance companies. Cause we would always spend an hour with patients.

Yeah. But the places like those mills that would see two or three of those patients and they get 15, 20, 30 minutes would benefit greatly off those patients. Yeah. Because they're getting pain the same no matter

Danny: what. Yeah. It incentivizes volume. This is the thing is If you're, if you own a business and you're looking at that and you're like, okay, I've gotta be, we know on average people need about $150 per hour a work hour in order to have a practice that's gonna be, in business, frankly and have enough profit to, to function.

So the math adds up. It's like, all right, cool. We now we have to see two people per hour. And if you really wanna have a profit business, then it's three. It's one of those things that it's. It's just the nature of how the business model works and if you wanna play that game and that's the way you want to go, and the high volume side is what you want to do.

You almost don't have a choice, right? And you have to go right over that direction. Whereas people like yourself that are like, man, I wanna like work with people. I want to, I don't wanna like palm people off on a tech, and have everybody do the same things. That's where you get, you really [00:18:00] can, I don't really see people function in that model very well unless there's some variation of a hybrid where they still want to take maybe Medicare or Blue Cross or something that has like a better reimbursement.

Even then there's still kind. Eating it for the volume because they're not gonna get that hourly reimbursement to be, in the one 50 s unless it's a specific, I'm sorry, some states are still pretty good, or hospital contracts they might get, but yeah, what option do you have?

And like for you it's okay, I either more volume or switch to

Chad: switch the model. Yeah. And the most frustrating part is there's a lot of pops around our area as well, and you ask them what they get reimbursed for the same charge. Two to three times more than what we get reimbursed for.

For a shittier service. I get it.

Danny: I don't understand how that works. Yeah, no, that's the truth. There's a big group down here I won't say their name but bi, a big PT group, multiple states they're in, and one of their. Managers one of, one of the people that was a manager for them as actually in our mastermind, and she was telling me that their reimbursement was around between 300, $400 per visit because they had a contract like an exclusive contract with one of the [00:19:00] hospital systems here locally, and they were still seeing two to three people per hour.

And I'm like, dude, do the math on that. And that's where it's frustrating when you hear people are like, You're out of network. You're, it must be because if you want more money, it's like absolutely not. If I wanted more money I would do that. Like

Chad: it's so much more profitable.

Yeah. I always tell people it's the act actually the exact opposite for us. We actually lost money by going out of network with insurance quite a bit actually. Yeah, quite a bit. To the point where I had to, I couldn't take back two other therapists cuz I couldn't afford to keep 'em on staff. But that was the direction that we wanted to go in and that was the vision that we saw for the company.

But it's just, yeah. People think that you're right. They just, you're trying to get greedy. You're charging all this money. It's no, I'm actually losing money. But I'm losing money for a good cause. Cause I wanna spend more time with you. You know what I mean? More money per patient in terms of our Right.

But in terms of overall, it's less

Danny: for sure. Yeah. Yeah. And I would love for you to talk about that transition a little bit because there's not a lot of practices, that I know of, that have gone from, out of network or in-network to. A complete transition to cash in a short of a period of time as you've [00:20:00] done this.

So what, talk, walk us through the hard parts and also what are the great parts about you not having to deal with it anymore?

Chad: Yeah. The hard part was actually the whole mindset thing, which is what you guys really harp on in the beginning. That was hard to get over because I've worked in the insurance model my whole entire career.

It was hard for me to be like, Hey, guess what? It's gonna cost this much now. Yeah. Hope you're okay with that. You know what I mean? And we strategically started going out a network with certain insurance companies that we either had less volume with or that were reimbursing us less. And then we just chipped them off, like one by one.

Some, we did a couple at a time. But the last one that we had was our biggest home, which was Blue Cross, which was 30% of our caseload. And we were like, man, yeah, if we get rid of 30% of our caseload, we gotta make sure that this is gonna work. So I actually, my main guy I had a conversation with him and we were like, we either hire somebody else because we can't keep up with the demand the way it's at right now.

Or we get rid of Blue Cross and we say, let's just go for it. And he goes, dude, let's do it. And I'm like, all right man, if you're on board, let's do it. We were doing the math and doing the numbers. We only really had to keep 15% [00:21:00] of those patients. It was between 10 and 15 because the amount of money that we were charging in our out of network price versus what we were getting paid in network, that's what would it take to break even more or less.

Yeah. And we did that. We kept 20% of 'em, which is great. And we still see 'em till today. So That's awesome. But I think the process for us. Giving people enough heads up, like we had to deal with the out-of-network process isn't oh, you just, you sign a piece of paper and you're done.

It's, it can take three months. Some insurance companies, it was six months. Wow. And I didn't read the contract on any of them when I signed them, so nobody does. So when I was like, oh, damn, 180 days, that seems ridiculous. But if that's what it is, that's what it is. You have to there's a whole system that you have to go through in order to do that process.

Yeah we just, we made that transition very slow because we weren't sure, because everybody says that it works, but you're like, I don't know. I'm still skeptical. But then once you see it working, you're like, all right, let's just do it. It's, it takes time to get there, for sure.

Danny: Sure. It's, it's a mindset.

It's, you got three daughters, right? Like it's not, yeah, it's not you and Katie don't have other people. You're supporting. You have [00:22:00] employees, which is the other thing that it's not You, these are good people, right? And you wanna provide, good jobs for them where they can provide for their families.

Like we have a lot of burden on us in a, in, in stress when it comes to all of the people in the ecosystem. So this is not a small decision by any means, and, for you guys, obviously, I know it's worked well for you at this point. What is it about this model that you're running now that you think is like such a big pro, obviously over the traditional kind of model that you move from?

Chad: It's a lot less stress, that's for sure. So we don't have to see as many patients, so we're okay with that, and that's the goal anyways. There's no stress with figuring out if you're gonna get reimbursed by insurance companies. The notes are a lot less way easy, so That's awesome.

Yeah, that's you actually, we just, my wife just started with us like a month. And she was like, so what do I gotta do for this note? I said, whatever you want. Yeah. If whatever you think is necessary to put on there, it's fine. Cuz half the stuff on there is irrelevant, because it's all the ins what the insurance wants.

The be that's the best part, and it doesn't take any [00:23:00] more time away from me on the weekends. Cause I used to have to do notes for two to three hours on the weekends just to keep up for the next week, and that was the worst. Because, when we first talked that the whole goal was to get to the point where I could spend more time with my family.

Yeah. Or have more time freedom, and every time you get to this next milestone, you forget about what your original goals are, and you just wanna just keep on growing and growing and you're like, shit, I could have done that six months ago. But you decided not to because your mind was focused elsewhere, yeah. More on the business than it was on your personal side. Yeah. Which has always been a problem for me. It's tough.

Danny: Yeah. I remember you telling me that, as it, yeah, it was like, I gotta be, I gotta be home for more dinners. And I, yep. I'm like, yeah, you totally do. It's it's funny man.

It's what we can get, we get, get competitive. We also, We have goals that we want to achieve and we're driven Sure. People. And I obviously see that with you. And it's just, it's frustrating to hear that people who are spending hours documenting this tedious shit instead of being at their kids' soccer game or whatever it might be.

And that's a trade off that people are making. Like even one of the last [00:24:00] guys that we hired came from the in, in-network world. He was running a clinic for somebody. He was like, my morning routine on Saturday morning was to wake up early and do two to three hours of documentation before anybody else got up.

And I was like, what a shitty Saturday morning activity to do. Dude, you could have been, and he's a big endurance athlete. I'm like, you could have been going on a bike ride, man. You could have gone on a run, could have done any number of things. And now that's gone. And I think the appreciation for that is, is huge.

Obviously like we know gross revenue drops versus the in-network model, and I hear this all the time when people are, they're like, they tell me they're in-network gross numbers and. Dude, that is, that's not what, that doesn't mean anything, right? Yeah. But like as far as profit goes, with this model versus the in-network model, what does that look like in comparison?

Chad: Oh way, we're way more profitable now as a business being, outta network versus a network. And on top of that, we're, we're able to not only be more profitable as a business, but we can actually, I feel like I can better predict the profits as well. Oh yeah. It's been so much easier to do that.

I don't have to worry about all the overhead of [00:25:00] hiring all these PTs. I hope I have that problem now, but I don't, I had that problem back then. The reimbursement was so bad. You're like, man, I don't know if they don't pay me this month, I'm, I don't know. We're gonna be really short this month.

So it's, that was always that stress of having to rely on those third parties to pay you. And sometimes they wouldn't, sometimes they wouldn't, and, but the profit margins are way better now than they were when we were in network. We don't have to deal with all the overhead of billing companies, we don't have to deal with, clearing houses and all that other crap that we used to have to deal with when we were in network.

So it's cut a lot of our expenses down by quite a bit as well, which is pretty sweet.

Danny: Yeah. And you guys do a really good job of. Ongoing work, continuity work. Can you talk about predictability? But really the recurring revenue is something that I think for the vast majority of in-network practices, it's very hard for them to build that into their model because it's not really what people are coming there for.

That's not what they've been trained to come there for. And, the predictability of knowing hey, if my recurring revenue is meeting my overhead at the start of the month, like [00:26:00] that is like a, such a different place to be as far as stress goes, as far as, being able to pay your people, being able to know that there's gonna be profit within the business to reinvest or take home, whatever you wanna do with it.

So what have you guys found success with on the recurring revenue side? The ongoing continuity, program side? What are you doing within pro. Yeah, so

Chad: I would say training is probably our biggest continuity program that we have now. We do the continuity with the PT as well. It's just not as, It's not as popular as the training.

Sure. It's, for us, it's almost easier to train to transition a patient to a training program or a training membership versus, say, Hey, we'll see you once a month for the next three months and let's just see how it goes. Which is still a good option for some people. But for those that we feel need more direction, But are like past the PT stage.

We can get them into training one time a week for the next three months. So it's been a great way to not only improve our revenue yes, but also our recurring revenue at the same time. Which is nice, and it's more beneficial for the patient too, cuz it's what they need. Oh sure.

You're not just selling [00:27:00] it to 'em, it's not snake oil, yeah. I think

Danny: for a lot of people, the, even the transition can be a little bit, can be a little tricky, right? Let's say you have somebody in their goals, they wanna get into a group fitness sort of style training but yet they're coming to see you because they just got hurt doing something like that.

They wanna get back to it. And for you to be able to say, all right let's create a bridge program where we're gonna, we're gonna train you to help, this is our goal. Or if your goal is you wanna do your first whatever it is. What a great opportunity. And I and I see certain people in the profession, they're like we're, what are we personal trainers?

And and other people, we look at it like you. We, I feel like we have a really cool opportunity to. Help people that are traditionally scared off by, the health and fitness world that maybe aren't as approachable. Or maybe they have some injuries and they're worried about getting hurt and there's a subset of those people that really benefit from having somebody like yourself or, one of your docs.

Take them through. Educate them. And I look at it more like consulting for the human body. We're teaching you how to take care of yourself and that's perpetuating itself to everybody else in your life. And they're [00:28:00] seeing that. And so I think it really depends on your skillset and obviously you guys have a strong background in that, so for you guys that are, that you're training what does that look like? How often do they, how long do they stick around with you? I, and what are you primarily helping people

Chad: with? Yeah, so for, to piggyback off what you just said, when we were at the Mastermind, we.

Fitness round table. And there was somebody that asked us the question and the question was, how do you turn off the PT hat when you're training? And I said, you never turn the PT hat off, because that's the benefit that they're getting by training with you. You know what I mean? And that's why you're charging so much for training because they want that element that you can provide them that PT service with.

The training on top of that. For anybody that's I don't wanna be a trainer, you're not being a trainer, you're still being a physical therapist, but you're, maybe, you maybe call yourself something else. It's all on the title. Moving specialist, I don't know. Whatever you wanna call yourself, but just know that, it's not a negative thing when you're doing training in a facility like this. People look at it as a positive thing cuz they're getting more for their buck, as opposed to not. So yeah. That's for starters. What was the question again? Sorry. No, I

Danny: was thinking about that one.

I, I [00:29:00] no you spurred me on something else as well, but I think that, I think for a lot of people, they look at like training as al almost like it's a bad thing, right? It's oh, I don't wanna train people. What the fuck do you think we're doing with people? Yes. Once I get to a certain point, all we're doing is.

We're progressing their exercise, we're teaching them, we're, we're holding them accountable, we're answering their questions. Hey what's the difference? I come from a personal training background and yep. I, you get to develop these really tight relationships with people.

And for some people, maybe that's small group, maybe they wanna work with a handful of people at once and they wanna leverage those, a small community and their skills, but, the ability to be a movement specialist, clinician, whatever you want. If you're doing, it's all the same stuff, just a matter of how deep can you go in certain elements, obviously of what we can do.

From the training standpoint which one do you find easier? Getting people into training or getting people into physical therapy? Training for

Chad: sure. Yeah. And that I, and it's, I don't know if that's because you mean if they're a new patient, like a new person calling?

Danny: Yeah.

Let's just say, yeah. Let's say somebody's, let's just say I, I call up now I'm trying to, I'm trying to build up my fucking arms dude. Yeah. Chad [00:30:00] looks like you helped me out. Call 'em up, but my back hurts. Yes. They're like, which one of these two things do you. If I'm like, yeah, I'm looking for a, I'm looking for a personal trainer or physical therapy.

It seems like there's so much overlap. It's just a slight difference in verbiage. Sure. Which one of those two things do you think is more marketable and easier to sell to general population? Yeah,

Chad: I, it's a tricky question because I actually have a patient like that not working on their arms, but she had a c l reconstruction like six months ago, and she's coming to see me later on this week.

But it was one of those where she's I think I need training, but I'm not really sure. I said why don't we do an evaluation on, you see where we need to go? Maybe we can do Four or five or six PT visits and then transition you to training if we think that's what you need. And they love that.

They love the, to be able to they know the plan. They've, you've already pre-framed that, the fact that you have training, which is nice. So it's like you can offer the, all these other services for these people and they're like, wow, I actually think that this could work for me. You know what I mean?

That sounds good. And if we don't use. Five or six of your visits, then we'll use a couple and then we'll save some in the bank. [00:31:00] We'll get you to training. And if you ever have pain during your training sessions, then we can just call it a PT visit. You know what I mean? But you're right. There's no, there's not a lot of difference.

We say that training is rehab, and rehab is training. That's a saying that we have here. So you could walk in here and not know if they're a PT patient or a training client. You wouldn't know the difference. Not unless they're on a table or something like that, but if they're both doing exercise, they both look the same.

So you're right, there's really not a whole ton of difference. And that's the good thing. There shouldn't be. I agree. The GT just adds that extra element of whatever it is you're doing, whether it's more manual or whatever, to get that patient to the point where they can tolerate more just exercise based, an exercise based

Danny: program.

Yeah. Yeah, and if you look at like long-term Achievement of health and wellness goals. It's a, there's lots of ways to, some people, they, they want to, Hey, look, I'm gonna, I'm gonna be the person that gets rid of pain and I'm gonna hand it off to somebody else. Maybe you have that person in house.

You could have a trainer, you, but I think, obviously I'm biased because my background is in, movement based kind of work, work with people, training, conditioning and I see so many positive benefits that we that we can bring to the [00:32:00] table for somebody, especially that falls into the camp of Frustrated have been hurt before, unable to hit their goals.

But also I think the other element that, that and there's some amazing trainers out there that I've worked with by the way and the difference that I see is in this high level trainers and with us, with our education, there's a level of communication that is significantly better than the average.

The average coach, the average trainer, because we work so hard on that's just such a big part of what we're doing and listening to people who are subjectives and getting buy-in and understanding that same, and my buddy Brett Bartholome, who talks about this all the time, and as I read his book, I was like, dude, this is, yes, this is exactly, what we do.

So I think there's an element of that, that you just, you haven't in initial rapport with people and you have a degree that gives you credibility as a huge, feather in your cap. And I think that there's a strong element. Clinicians to be the leaders in health and fitness. Whether that's training other people up, whether that's doing it themself, if that's what they really like to do, because it's fun, man.

You get a chance to train people and they start hitting goals and they're like, taking pictures after their first 5K and they're [00:33:00] shouting you out and, thanking you for helping them get to that point. That's amazing. Like why outsource that? That's the best part.

Yeah. The people for.

Chad: Yeah, I mean it's funny because my wife just had a she just had another eval today and she sold her a 10 visit pack and she's wow, I believe she bought 10. I'm like did you tell her to buy 10? She's yeah. Then she listened to what you said, so that's your recommendation.

And she was coming from the same thing. She came from an insurance based. World as well. So it's, we're like, oh, I guess you can do this much, but maybe you could do that much. It's no. They want to know I screwed up when I first started, cause that when I first made that transition, I'd be like I, I guess you could do six, but 10 would be okay too.

Be like which one is it? You're the professional. Tell me what the fuck do you know? And I'm like, damn, you're right. And she was cool, but she opened my eyes and I'm like, you're right. Let's do the 10. So it's like one of those. They just wanna be told, patients just wanna be told, the direction they need to go in and that's why they're coming to see you.

And if they don't like your answer, then that's fine, but it's one of those where I feel like you just have to be confident with what you're saying and the direction and the plan of care that you have for that patient. And it, the buy-in it's just so much easier, cuz you're not lying about it.

That's just what it is. You're just, you're just looking more confident saying it. And that really does [00:34:00] have a lot of impact on what these patients are doing. And that was the hardest thing for me for sure in the. And obviously, just like anything else you can put the reps in.

It just gets easier over time yeah.

Danny: Yeah, it's difficult. I. It's, especially if you come from an in net in-network world, it's just three times a week for six weeks or whatever. It's just the standard. That's what, and a lot of times it just says it on the script. So somebody else has basically just put it in there for you. Yeah. And for you to be able to be confident about, look, I need to see this number of times to solve this issue, for the long term. This allows us to build out a plan of care with you, hold you accountable and then, for us as well, we are committing to solving this problem with you.

And that means a lot. I think that it's just something that it's, it works when you're, you have conviction and that's kind hard to build early on because you're you're like what do I say? Did I say this? Did iframe this? It's dude, just be confident with your skills and what you actually need to see somebody for.

And they'll convert to, to wanna work with you. What, tell me this. What's the, how is the. The relationship with working with your spouse? Cause I work with my spouse and I always find it's [00:35:00] interesting to talk to other people that do. So what's that relationship been like?

Like pros, cons, like what advice do you have for people?

Chad: Honestly, it's been great so far. So we both went to the mastermind, which is awesome because I wanted her to that event. I wanted her to get not only the mindset, but I also wanted her to meet other people that she's like big into pelvic floor physical therapy.

So I wanted her to like, meet those people that were doing it and, see if she could, get in a different frame of mind cuz she, she's been out. The world for a little while. So I wanted her to get back into it and she came back and I've got like this whole like Monday schedule thanks to Jake.

So Jake's like Jacob was talking about Monday so much. He's yo, you gotta check out Monday. She's okay. So I have this, I'm like, got 20 notifications this morning about Monday. I'm like, calm down. But it's awesome because we need that structure, so far it's been great because we both know what our strengths and our weaknesses are.

So she's very strong at organiz. As I'm, I just wanna help people and I love networking and I love the relationship side of it, so that's easier for me. She's much more of an introvert and she's I can just do all this stuff behind the scenes. And I'm like, great, do that so I can go out and, make, get more people through the door.

That, that's where we've been [00:36:00] found to be like, pretty good. And I will say that the conversations at home have been a little bit. Businessy lately, which I don't mind, but I know that's gonna get to the point where it's gonna get a little tiresome. So we've made it a goal that we can only talk about business at certain times, other times we can't talk about it because it's gonna get outta control and we're I can see that running down, a slippery slope, but we've only been doing it for the last month. But just watching her in there today, just treating a patient and a patient just walking out feeling happy and with a smile on her face.

I'm like, man, I'm so proud of you. That's awesome. Yeah. So it's cool to like work in the same. Places your wife. I've been hoping that was gonna happen ever since I started this. So I'm glad it's actually coming

Danny: True. That's so cool, man. I, yeah, and the fact that you both are clinicians is it, it's even better because, the women's health side is, it's just no different than any other niche in an in-network world.

Sure. And even difficult, they need even more time with people and it's is even more of a sort of like frustrating, very sensitive problem that for a lot of people, they don't even, they don't even get help, with that. And for her to be able to step into that and, at the Mastermind to be able to break into a small group and have a [00:37:00] dozen other, people that.

Actively like running practices like that. And somebody like, you take like Lauren from the Thrive team or right. You take, Brooke Miller and let them, chat with each other about what's going on. I walked into that group and I was like, this is like the most fun group.

Of everybody that we broke up into, I was like, you guys are having a great time. And it's just cool to be able to share some of those things. I think for her to be able to see, what people are doing and gain some confidence from that, especially getting back into the profession and in this capacity is is huge.

But yeah, I think working with your spouse, if you guys have complimentary skillsets, Which just sounds like you do, you're classic visionary. She sounds like a classic integrator. Yeah,

Chad: we took that test. It was pretty clear. Was it? Okay, cool. Yeah. Dude,

Danny: we, yeah, which was good. Yeah, it was.

And that's great because you wanna know where your strengths are and if you, yeah, if you guys offset each other, it's just such a good synergistic relationship. And ultimately, who can you trust more than the person that you're spending your life with? As well as have say over exactly when you want to go, do whatever you wanna do.

If you guys want to go. Away for a week together, or it's cool, like [00:38:00] you pick when you wanna go, you don't have to ask anybody.

Chad: Yep. Yeah, that's been the best part, just knowing that if I'm not here, I know everything's taken care of because nobody's gonna treat it any better than us.

Cuz it's just how it's yeah. So it's taken a lot of stress off my shoulders for sure. Which is great.

Danny: Yeah. That's cool. Tell me a little bit about the vision of Proform. So you guys, like, where do you see this thing going? What do you want it, what do you want this to look like?

Yeah, so

Chad: I think in the next three years, I would love to have another one to two PTs on staff. I'd love to get to the point where we. Add on to this place. But this is enough space for us, but the PT side and the training has been always been great for us and we just wanna keep on building up the training.

We're gonna be initiating some group training. We got Katie doing the pelvic health stuff now. So we just wanna keep on adding as much as we can to the community as possible. I'm not the type of guy that wants to have satellite clinics. I would rather have one big place. Yeah. So I would rather add onto this spot.

And not lose my awesome employees here to go run another spot. I would like to all have, all of us have this [00:39:00] powerhouse just crushing it just in one spot, and that's just always been my vision,

Danny: So I feel like it, it is harder, with we, at one point we had three satellite offices in our main office and.

The challenge, it's almost like having remote employees. Cause the challenge is the culture, cause when everybody's together's that sort of team feel. I completely agree with you. And the management of multiple locations is tricky. In comparison to one, bigger more well-established more well-established place.

And again, your guys are, you're running into each other. You can bounce questions off each other in terms of critical thinking or whatever, some patient thing that's going on, or play a little bit of basketball, whatever it might be. You, you can't that's just.

That's the fun part. And I think that's what totally, for a lot of people that are just starting out they're scared to move into a sa, a standalone location, and for you, you went from a satellite office in the back of a, chiropractic clinic, growing that a little bit bigger and then, into a pretty sizable standalone space.

And I'm assuming you would do it all over again with your standalone space. Totally.

Chad: I definitely would. Yeah. A thousand percent. I wouldn't [00:40:00] change anything. I, I have regrets from ca for taking insurance in the beginning, but it's made me appreciate what I'm doing more now. So I don't regret it.

It sucked, but I don't regret it, and I'm glad that it's in the past, but it definitely made me appreciate the profession more. It made me appreciate what we're doing in our vision now, cuz you get stuck in that rut, man. It's hard to get out. So it's, that was the best part I think that came out of taking insurance.

Danny: Yeah. I think the thing that's sad for me to see, and it's also super cool for me to see people like yourself and many of the other clinics that we've that we get a chance to work with is this sort of this frustration with. The way that things are, the traditional kind of model, the way that things are, where it's I guess I just have to do notes every weekend.

Or I guess I just have to see two to three people an hour, or I guess I just, have to expect that I'm gonna have these massive accounts receivable that are maybe gonna come in. Yep. Or not, or whatever. There's some cases gonna settle and they just assume that's just the way it is.

So if I want to function in this profession [00:41:00] and I have to do these things, And that takes a lot of people and drives them away from the profession. And you see this in, and no offense to anybody that wants to go and, take their skillset and be in a non-clinical role. You do what makes you happy.

But I hate to see really good clinicians that are moving away from it, not because they dislike the profession, is because the profession isn't really fitting their lifestyle. For what they, for how they wanna work with you, but also for, the. Flexibility they may or may want to have or the time they wanna get back by not doing certain things versus asking the question like, how can I take this skillset that I have that's super valuable and unique.

And how can I get it to work for me and what does that look like? Yeah. And for you. That's exactly what you guys have done. And it's just so cool to watch the business flourish and be able to support the mission, which is ultimately, to help people. And in order to do that, you need more time.

You need to build those relationships, and you just can't do it if you're only seeing people for, 20 minutes at a time. And it's a transactional sort of agreement. Where, and then once insurance is done they're out, they're outta here, and they don't value you [00:42:00] out anywhere outside of that.

So it's cool to watch you guys be able to, Shift that and be able to make that transition successfully and have the business be able to support, generating both time and financial freedom for you and your family

Chad: over the long term. Yep. I was definitely guilty of thinking like that for sure.

When I graduated 10, 12 years ago that, it wasn't really a hot market, if I should say it, that's the correct term, but it wasn't really booming for sure. It was very much frowned upon and it was like, it'll never work. It'll never work. And there were a few people out there that were doing.

But they were like unicorns, yeah. But now I feel like it's getting more and more popular and it's getting more recognition. People are starting to see it more. I wish I graduated nowadays and not wasted the last 10 years of my life, but it's all good, yeah. I don't call it a waste, I guess it's probably a bad term for it, but it's just different the way it was.

It's actually funny cause I actually saw my my previous boss that I used to work for in Rhode Island, like three weeks. And we were talking about that, and he was like, so you don't take an insurance anymore? I said, Nope. He said, you, you and I have to talk, man. I was like, you gotta do that. He's it'll never work where I am.

I said, stop. I was like, that's the problem. That's the problem. Yeah. I said, actually, I know five clinicians in [00:43:00] your area that are in my group that are doing it, so that's no excuse. He goes, all right maybe you're right. I said that shit out. You

Danny: know what I mean? Even if they don't I almost feel if it's a, if it's not a massive like.

Corporate owned, investor backed or just really big privately owned, which is very few in-network practice that are not, don't have some sort of private equity money involved or anything like that. It's almost it doesn't make any sense not to at least look at. Dropping certain contracts and at least trying to create a hybrid model to improve your efficiency with people as well as your profit.

Because that's the key is what are you keeping of that revenue? And I feel bad for a bit clinics like this that, they're like one or two. Small clinics in network and it's like death by a thousand paper cuts. They're just less each year. Less each year.

And there's, we stack on more and more volume, or we work longer hours and it's unsustainable at a certain point and then eventually they get frustrated and they move on to something else. And, so I almost feel like everybody has to take a serious look at that if they really want the model, to work for them long term.

Cause it's not like insurance is gonna say, you know what? [00:44:00] We've been real jackasses. Let's go ahead and let's increase what we're paying you this year. That

Chad: doesn't happen. No, it's definitely going the opposite way. It's not going that way for. Yeah. It's not, that was our big thing. Yeah.

No, you, I made that move a couple years ago. I was like, that's it. I'm done. And you're gonna, that was me again for another year. I don't think so. After I got penalized, after you guys found out that P QRS sucked and I got penalized for nine. Oh my God. I'm like, that's

Danny: it. I'm done.

Never have to deal with it ever again. Man. That's awesome. Nope. Nope. Chad, we appreciate you doing this on your off day. I know you got plenty of other things you can be doing. I if anybody wants to kinda learn more about what you guys are doing or see what you're up to where can they, find you guys on your website your Instagram channel,

Chad: all that.

Yeah our website is proform ptma.com. Our Instagram is proform ptma. We do a lot of stuff on there. We have movie Mondays. We do I love it. We do skits all the time. We try to make it fun, for everybody. Those are our main sources of of contact, for sure.

Danny: Yeah. Yeah. Cool. Guys, go check 'em out.

Great example of a transition from in-network to a a cash-based practice that's thriving and really doing some cool, fun stuff. Really cool culture. So as an [00:45:00] example of somebody, to model and just see what they're doing, go check 'em out and chat again, man. Thanks so much for your time today.

Really appreciate it. Thank you, Danny. I appreciate

Chad: it. You got right. See ya. All right.

Danny: Hey, real quick before you go, I just wanna say thank you so much for listening to this podcast, and I would love it if you got involved in the conversation. So this is a one way channel. I'd love to hear back from you. I'd love to get you into the group that we have formed on Facebook. Our PT Entrepreneurs Facebook group has about 4,000 clinicians in there that are literally changing the face of our.

Profession. I'd love for you to join the conversation, get connected with other clinicians all over the country. I do live trainings in there with Eve Gigi every single week, and we share resources that we don't share anywhere else outside that group.

So if you're serious about being a PT entrepreneur, a clinical rainmaker, head to that group. Get signed up. Go to facebook.com/groups/ptentrepreneur, or go to Facebook and just search for PT Entrepreneur. And we're gonna be the only group that pops up under that.

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