E714 | PT Biz Clinic Road Trip Lessons Learned

In this episode of the podcast, Doc Danny shares his insights and key takeaways from his recent PT Biz Clinic Tour Road Trip across the southeastern United States. He discusses how the landscape of cash-based physical therapy practices has evolved over the past decade, highlighting the potential for scalability even in smaller markets.

One of the key points Doc Danny emphasizes is the changing perception around scalability in cash-based PT practices. He notes that it is now possible for clinics to thrive and grow significantly, even in towns with populations as small as 10,000. This shift has been driven by highly skilled clinicians who are able to provide specialized expertise and stand out in their niche.

Doc Danny also touches on the importance of branding in the success of these clinics. He observes that clinics with strong and cohesive brand identities tend to experience faster growth and attract both clients and talent. Investing in branding, including elements like logos and design aesthetic, can convey professionalism and set clinics apart in a crowded market.

Furthermore, Doc Danny dispels the myth that cash-based PT practices can only succeed in larger urban areas. He highlights the success of clinics in small towns with populations under 10,000, citing factors like lower overhead costs and less competition as contributing to their growth. He also identifies midsize towns as a sweet spot for cash-based practices, where skilled clinicians can thrive and make a significant impact.

Overall, Doc Danny is optimistic about the future of cash-based physical therapy practices and the opportunities for growth and success in the industry. He believes that this model not only allows for high-quality, personalized care but also supports clinician work-life balance and longevity in the profession. This podcast episode offers valuable insights for physical therapy professionals looking to expand their practices and make a positive impact in their communities.

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Podcast Transcript

Danny: 

Hey, real quick, if you were serious about starting or growing your cash based practice, I want to formally invite you to go to Facebook and join our PT entrepreneurs Facebook group. This is a group of over 6, 000 providers all over the country. And it's a pretty amazing place to start to get involved in the conversation.

Hope to see you there soon. Hey, are you a physical therapist looking to leverage your skill set in a way that helps you create time and financial freedom for yourself and your family? If so, you're in the right spot. My name is Danny Mattei and over the last 15 years I've done pretty much everything you can in the profession.

I've been a staff PT I've been an active duty military officer physical therapist. I've started my own cash practice I've sold that cash practice and to date my company physical therapy biz has helped over a thousand clinicians start grow and scale their own Cash practices. So if this sounds like something you want to do listen up because i'm here to help you

Hey, what's going on? Doc. Danny here with the PT entrepreneur podcast. And today we are talking about something I got to do about a week ago. And that is the PT biz clinic tour road trip that I went on. This is something that I've actually been planning to do for for years, and we've had a chance to go different places and check out different clinics of clients that we work with and be able to share their story and share what their clinic looks like.

And those clinic tour videos are actually on our YouTube channel. So if you haven't checked those out, head over to YouTube, go to our PT biz channel, and we have, I think, 8 to 10. Clinic videos in there of different of different clients that we have, that we worked with and showing their space and talking to them about their entrepreneur journey and what's next and highlighting some of the things they're doing that are unique within their own space and the niche they work with.

And this has been a lot of fun for me, just something I've really enjoyed. I think that the more time that I spend working with entrepreneur entrepreneurs in the clinical space, the more time I realized that I'm just like, Such a big fan of everybody in our space. I guess partially that just comes from the fact that I'm just like, they are, I'm just like them.

It's, this isn't a, I didn't go to business school and decide, okay, I want to work with a cash based physical therapist, I don't know. I don't think there's anybody sitting at Harvard's, a business school thinking to themselves, this is a niche that I just can't wait to dominate, like it's not happening.

And for me I just love nerding out with these people because I'm one of them. And we could just sit there and talk about clinical stuff and how, what the niche they're working with. And then we can dive in the business side of things. And then, the personal side of stuff and their families and the time freedom, the businesses are helping them achieve and the challenges that they have.

And I've gone through all this shit and it's so fun for me to be able to, go and see their. clinics and talk to them and meet their spouses and their, and their families in some cases as well. And just see the areas that they're in and learn about, the different demographics and niches and strengths and weaknesses of different areas and all that.

And I've just really enjoyed it. And it's something that I hope to do a lot more of, but one of the things that I've always wanted to do was a road trip. And this goes back to. Back in the day on MTV, I don't know if I'm dating myself here. Cause I can't remember. I think it was in the mid nineties.

There was a show that started called Road Rules, and it was like a group of, I don't know, six people or something that lived in a van together, like a RV, and they had to drive, across the country or whatever and do these different challenges, and I always wanted to do it. And I even I even tried out for road rules whenever I was in college.

I actually don't know if this is a legit tryout or not. I was at a bar and they said they had a tryout for this show. And you go and whatever, they interview a little bit and then they shave your head. That was like part of it. Are you willing to let us shave your head? And I was like, absolutely.

And then I didn't get the, I didn't get the the job. But I did have a shaved head along with probably a couple dozen other people I saw around campus. The next day, we all realized that we decided to make the same bad decision. But I always loved it. I wanted to go on a road trip. I want, I thought it'd be awesome.

And we decided this time that we were going to rent a B class Sprinter van, like A little pop top sprinter van and myself, one of our staff members from our sales and marketing team that also does a lot of tech video stuff for us. And then our videographer lived in this van together for a couple of days.

And it was awesome. We had a great time. It was, it's a road trip. Love road trips, with friends. And the best part was that we get to stop in and check out eight different clinics in different markets. So we went from Atlanta to Woodstock, Georgia, to Chattanooga, Tennessee, to Knoxville, Tennessee, to Asheville, North Carolina, to Greenville, South Carolina, and finished in easily South Carolina before we made our way back to Atlanta over the course of three days.

And it was a lot of fun. It was something that You know I wanted to go to some of these smaller markets and really be able to highlight some of those so far, we've been to Boston, Phoenix, Atlanta I think that's it just three big cities basically. And now we have these other ones that are a good bit smaller.

And I have a few takeaways from this that I learned really, there's four, four big ones that I wanted to share. Because, I feel like there's different, like I said, pros and cons in different markets. And now that I've been to really big markets, midsize markets, small markets, and I work with these people on a daily basis, it's not like I'm unfamiliar with their businesses, but to actually go to somebody's town.

To actually see what it looks like to actually see what the other business are, our businesses are around there, what it looks like in their downtown areas, what it, what it looks like in terms of population and opportunities and everything that's there. It's very different to be able to see that and to understand, better understand their business, their.

Aspirations and options that they have in their area. And there's a couple of things that that I took away. So number one is that scale is no longer a question. So when I started athletes potential with Ashley in 2014, we, a hundred percent thought scale was not possible. And we had friends, mentors, other people basically tell us that, yeah, if you want to go the cash.

Based route that you, you're just gonna, you're going to build a, maybe build a schedule that's busy yourself, replace your income and then some, but other than that, you probably aren't going to be able to grow it past yourself. There really weren't any examples of pure cash clinic that I had seen that had grown past one provider.

So I didn't really even have an example of somebody that had done it at the time. I knew people that had, were busy with their own cash practices, but not really a scale past themself to another provider. And I would say over the last 10 years, this is one area that has changed the most.

Not only is it possible to scale, but it is possible to scale. In towns as small as 10, 000 people, like we were in Easley, South Carolina with Tony and Tony's practice off the block is going to be awesome. It's already grown past herself with her and her husband Cole, but and they've done an amazing job and this is a town of 10, 000 people and the ability to grow a legitimate Size clinic, like a big clinic in these smaller towns.

It's very possible in some ways. And even talking to Tony about this, I feel like she has such a unique advantage because she's taking this like very high level clinical experience. Then normally those type of the best clinicians, maybe they gravitate, gravitate towards bigger cities because there's more opportunity.

There's bigger clinics. There's higher there's like more education as far as, universities are concerned and maybe they don't want to be in these smaller towns because they don't think they're as good of an option. But for her what's interesting is It's like the opposite like it's just like she's taken what would be a very high level Skill and applied it into a smaller town and they're not used to having that level of competency of quality with a clinician it's if you were to be this amazing chef and you move into a small town and all of a sudden They're like, oh my god, why is this bad?

Burger so amazing was because this guy is like legit chef and now he makes burgers in a small town or whatever. Like he just crush it, kill everybody because it's so much more talented than the other people that are in that area, assuming that they're good business owners. And that's what I'm seeing with these clinicians is these are amazing clinicians that are just absolutely light years, better than other people around them in a smaller area.

And. And it's a huge benefit to them. We saw this in Chattanooga, which isn't a massive town. It's not a small town. I would say it's like a midsize market. Same thing with Knoxville, which is a little on the bigger side and Asheville, which is a bit more of a midsize market as well. We just saw these amazing clinicians are people are gravitating towards them because they can see that they're.

It's really good at what they do. And they're really dominating a niche quite well. Scale is no longer a question. It's no longer a question of whether you can grow past yourself. It's just a matter of whether you want to. And it doesn't matter if you're in a big town, little town, whatever.

It's just a matter of whether you want to, whether you're willing to work on the skills necessary to be able to grow past yourself and build a business around you that supports other people that's it's. So it's not an excuse that a cash practice doesn't work anymore for that. They do.

And they scale in small markets to big markets and anywhere in between. The second thing, branding matters. And. As I looked back on this, we went to eight clinics and the ones that were doing the best, that were growing the fastest, they had the best brands. So they had the best and this isn't just like a logo, by the way, they had the best sort of cohesive brand identity within their space.

Their logo, their colors, accent colors pulled over into, the color of chairs in an office or something like that. Consistency throughout, like everything that flowed really well in spaces that identify well with a brand. Those clinics were busier, we're growing faster and we're hiring more people.

So this is not something that I'm naturally super interested in. I. I'm not a detail sort of oriented individual. I am not going out of my way to try to figure out what shade of blue was right. With our logo, I was just like, Hey, jump out of the airplane, build the parachute on the way down. But I think that's a mistake and understanding your brand.

And making sure your brand is consistent and pulled through throughout your entire business, whether that be a presentation that you give a color that you choose, a piece of art for the wall anything, your websites, all of these things cohesively working together. It means something to other people, whether that is like consciously or subconsciously, like people identify with consistencies and brand.

And. That's a powerful thing as far as your business is concerned and the ability to attract talent, but also customers and customers willingness to want to refer people to work with you. It's a level of professionalism that they feel proud to refer their friends to to go be seen by you.

And if it came down to the two providers, the same skill set, same outcomes they can get, right? But one is in a facility that looks like an absolute. Dumpster fire. And the other one is in a facility that looks great, that has consistent brand, is clean and organized, and everything flows well. I can promise you, you're going to get more people referred to the clinician with great branding and a great design at their facility than the person that is in just a really poorly put together facility, even though they skill set wise are the same, can get the same outcomes.

So Really something to keep in mind as you are investing in your clinic, as you grow your brand and pulling your brand together, this doesn't have to take a lot of money either, by the way. It would be more money than doing nothing, but it takes really intentionally thinking through this or getting some help from somebody that maybe is a designer or has more of a design.

I skill set so that you're not missing these things. And you're able to really have a consistent brand in your business as you scale. Hey, sorry to interrupt the podcast. I have a huge favor to ask of you. If you are a long time listener or a new listener and you're finding value in this podcast, please head over to iTunes or Spotify or wherever you listen to the podcast, and please leave a rating and review.

This is actually very helpful for us to get this podcast and really help them develop time and financial freedom. So if you would do that, I would greatly appreciate it. Now back to the podcast. The third thing, and we already touched on this, but small towns work. We've seen this now for years.

We even have a case study that we put together looking at. Towns that were small, like sub 10, 000 people and the clinicians that were there and how they were doing, and we've seen it, and this isn't the norm, but if your town is like a thousand people, like we've even seen them work in a town that size and now they may have some other small towns around them.

So maybe. Cumulatively, if you add them all together within a 30 minute drive or so of each other, maybe there's 10, 000 plus people or something. But I never ever would have said a cash based practice is going to work in a town of 10, 000 people 10 years ago. No freaking chance. I wouldn't have even thought that they would have worked in a midsize market like a Memphis or like even in, in Georgia, right?

If you look at Columbus, Georgia, or Augusta, Georgia, which we have businesses, we work with in both those cities, which are around, let's call it a hundred to 200, 000 people. Maybe it's a little bit more now in the surrounding areas, but these are not Big markets and I wouldn't have thought they worked there and ironically I started my practice I guess seeing patients in columbus, georgia when I was still stationed there, but it was very small I was just one off I see people here and there just to see if it would work And people would pay me like 150 bucks to work with them for an hour in a crossfit gym and but I definitely didn't think well this could grow into a full time business I just thought all right, this could be a cool side business And eventually one of my friends, Nate Henry, ended up taking over that clinic in Columbus, Georgia, and ended up even growing it more into a sizable side business.

But even still, I wouldn't have thought that it would work, especially not in a smaller market. But what we saw with these markets was Like the smaller towns, there's unique advantages to those. I think the big challenge that they face is finding people that want to work in those environments.

That's where I've, I feel like they have the biggest challenges as far as scale is concerned, but. Office space is way cheaper. It's, it's so much less expensive than if you're in a bigger area. Like I said, your skillset is probably significantly better than everybody else around you.

Like you're just better at what you do if you're really high level clinician and you focus on building a practice like this in a relatively small town. If you're good at local marketing, It can be a massive advantage. These smaller towns are more community centric. If you're a part of these different niches that you want to work with, the part of the local community, you almost need to do no other marketing outside of that, and you can grow past yourself.

It's really interesting how these are developing and the opportunities that are out there. If you. I grew up in a small town and you want to move back there and you don't think you can build a cash based practice unless you're in Manhattan, or the Bay area or Seattle or Austin, Texas, or it's it's just not true.

Like you can do it in some pretty damn small markets. And I actually think the sweet spot is markets like Asheville, Chattanooga, Greenville, and. Nashville not Nashville, Knoxville which Knoxville would be like the biggest of all those. I think that's like the surrounding area. It's like a million people.

But anywhere between a couple hundred thousand and maybe a million person population is a really good sweet spot where you still have lower cost for first fixed spaces. You still have less difficult competition, but you still have a lot of people and a lot of people that see a lot of value in what you do.

So I really, I've seen that now for a couple of years. I think those are really sweet spot markets as well as the cost of living is lower and where you can charge is relatively similar. What somebody can charge in Knoxville, Tennessee, Chattanooga, Asheville, Greenville is basically the same as Atlanta.

But the cost of space here for me would be higher. The comp like the salary and compensation and benefits is going to be higher in atlanta because cost of living is higher But yet I can't charge Significantly more I can charge basically the same and my fixed costs are going to be higher here.

So great It's a great win in those markets. I think those are really some really great areas for expansion of clinics over the next, five, 10 years in particular, I think those markets will see more people move to those. And if you're in one of those, then you have a really good opportunity to scale before you probably have even more competition than you do do now.

The last thing is that the bottleneck now is people and space. So every clinic that we went to had either just moved into a standalone space. Or they needed to expand into a bigger space. And some of them had recently, within the last year or so, moved into a standalone space and still needed to move into a bigger space.

And they're having growth problems. These aren't like, Oh, I can't find any clients problems. These are growth problems. I need to hire people. I need to hire another person. I need to move into a bigger space. I need to talk to bankers about. Loans for expansion. And and people were doing some really cool things with these even like one of the clinics We went to it's a golf niche and they had a trackman Like 50 000 simulator, in the space and it was awesome It was so cool fit the brand really well and even this is a relatively new clinic This guy's going to grow out of his space In no time, like they're going to crush it.

And then all of a sudden he's going to have to figure out where do I go next? Because the space is not going to be big enough for his company, once they hire one more person, basically which could happen quite quickly and especially leveraging. Pieces of technology like that are usually not seen in PT clinics is a huge unique advantage for him.

And also being able to intelligently leverage debt to do that. It's just a really cool thing to see and a fun thing to do. I thoroughly enjoyed hitting into the simulator and learning about what areas of my swing I needed to I needed to improve. I totally get why people would want to.

Go in and work with somebody like that so they could get objective data for their golf swing. If that was my like really passion and my hobby, I would be all over that. I like to play occasionally, but it's not really my thing, but some people, it's like a big deal. And. If you find somebody that has a a simulator like that and understands the mechanics of how to make you move better, hit the ball harder, play and be more resilient, all that dude, he's got you, he's got you for life.

So the bottleneck is going to be finding people that you can hire within your space and the physical space itself. And the nice thing I would say on the physical space side, in most markets, Commercial space is easier to find now than it was. In some cases, five years ago. Some of that is because a lot of people have gone remote for offices.

So this might not be industrial spaces, warehouse spaces as much as office spaces. So certain types of commercial real estate are going to be easier to find and negotiate, and you can get really Big rent discounts in some places. I was talking to a colleague of mine in a business networking group that I'm in and she has a skincare company.

Like they, they sell Skin lotion. I know nothing about it really, but anyway she's doing great. And she has a team of 50. And when she moved into a new space, she's in the Bay area. So she's in Northern California. She negotiated 50 percent of the list price of rent because no one's looking for office space the same way, that they used to.

So she got half off basically for what they wanted for rent for that facility. You have a great opportunity to move into spaces at discounts in a lot of places. Sometimes there's like very vibrant downtown areas that maybe they have no issue with finding tenants that you may not be able to negotiate much with.

But as far as, certain areas, it's very much worth testing and seeing if you can push the boundaries a little bit about what you can get as far as rent goes, or maybe some of the compensation they're willing to give you from a tenant build out standpoint, you definitely have a better option and likelihood of doing those things now than you did even five years ago.

So the space is a little bit less of a constraint. The people is where it's at finding people, finding the right staff, training the right staff, leading your staff the right way. That's a huge bottleneck for a lot of people. People are where it's at, and it's cool to see the growth problems that people are experienced experiencing are people in space, which are good problems to have.

They need a bigger space because they're too busy. They need more people because they're too busy. All of that went back in the day it was hard to find clients. 10 years ago, I was teaching workshops like a couple of times a week and trying to explain to people why I didn't take their insurance.

And now it's such a better landscape to be able to have those conversations. People are much more aware of these sort of concierge based practices. A lot of people are looking for these types of practices and they. They don't want to go to the hospital. They don't want to go to an in network clinic They want somebody's going to be more specific to their needs understands their niche understands what they want to do And they want to they don't have a problem paying for professional Help with that and they're seeking you out because they want that expertise That is a huge difference from what I saw 10 years ago, and it's happening in every single one of these towns is happening with every one of these clinicians that we talked to every single one of them had either expanded to a new space was looking to expand a new space.

It just hired somebody or was looking to hire somebody. All of them. None of them were like, man, it's just not working well. I'm going backwards. I'm struggling to get any traction. None of it didn't happen with anybody. And it was so cool to hear. It was so fun to go see their spaces and just to be able to like, enjoy the success they've had with them in their space and to be able to just make a fun trip out of it with some people.

I enjoy being around that, that we work with. And it's just a cool experience where we had a mini road rules. For ourselves, we knew any weird challenges or anything, but we did stop at Bucky's twice. I don't know if that counts which is always a fun experience. But it was great. I had an awesome time.

I want to share these things with you. And to summarize them, the four are scale is no longer a question. It's there. It's there. It's happening in big markets, small markets. Like it's not a constraint anymore. Branding matters. Focus on your clinic, focus on your brand, make it look good. It's worth it.

It's important. Small towns work, whether you're in a, midsize market or a really small town. I think as long as you're in a town of 10, 000 people or bigger from what I've seen, you can still grow a clinic even past yourself. And the last thing is the bottleneck for most people now. that are, that are having success in these clinics, it's going to be people and space.

And these are two growth problems, not bad problems to have. So I am very excited for the future of, cash based practices for the scale opportunities that people are going to have over the next decade or so, or longer. And it's just a, I think it's a bright spot within the clinical world where within, In a healthcare environment with so much burnout and so much negativity and challenge with people being able to have work life balance.

I feel like we have such a sweet spot as physical therapists in particular to be able to have normal work hours, make a meaningful impact on people do so in a way that lower volume so you're not burning those people out. Let them use their skill set the way it deserves, the way that they've trained themselves and spent so much time and effort to become great clinicians.

And if you have a practice that you're growing, you should really look at the growth opportunity you have as an opportunity to save clinicians from leaving our profession. And I talked to a number of people on this trip that were staff members that were literally, dude, I was going to do something else.

I was going to go into medical sales. I was going to be a realtor. I was going to do, and it was, it would be a travesty if we would lose these people. They're great clinicians. And all of a sudden you put them in an environment where they get a chance to use their skill set in a very pure way, create a relationship with somebody in a very unique way, help them with these physical, issues that they're dealing with.

They get so much personal reward out of that and so much satisfaction with using their skillset the way that they want to that the burnout goes away. Longevity is there in their career. They're happier. They're helping people live the lives that they want. Active, high performance, pain free lives.

It's such a freaking win and I'm so excited I get to see it. Firsthand, and I can't wait to do it again.

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