E633 | The Hardest Clinical Business Stage

In this episode, join Doc Danny as he discusses the toughest stage of starting a clinical business - the mental hurdles that come with believing in oneself. Danny emphasizes that skill-wise, this stage is not as challenging as it may seem. To overcome this obstacle, he outlines three essential steps that must be taken: transitioning to a standalone space, hiring administrative support, and bringing on board another clinician or fulfiller.

However, Danny acknowledges that this process can be time-consuming and fraught with challenges. From finding a suitable commercial real estate to vetting a reliable commercial realtor, the path to success may not be smooth sailing.

Furthermore, the task of identifying and convincing the first clinician to join the team adds another layer of complexity. Despite these obstacles, Danny reassures listeners that once this stage is conquered, the road ahead becomes clearer, allowing individuals to establish their own team of clinicians and develop a solid infrastructure to foster business growth.

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Podcast Transcript

Danny: Hey, real quick before we get started, head over to Facebook and join the PT entrepreneurs Facebook group. If you haven't done so yet, we have monthly live trainings going on there. There's an opportunity for you to join in the conversation instead of just listening to what I have to say on this podcast, as well as the people that I bring on.

And it's a really cool place to join about 6, 000 other clinicians that are. Honestly, trying to change the landscape of our profession through these cash and hybrid practices. One other thing that's really cool is we have a guide in there. That's a quick start guide. When you join, you can go and check this out.

There's about seven videos that we've curated that are the most common questions we get in the best case studies that we've found to really help you start, grow, and scale your practice up to seven figures. So if you haven't done so yet, head to Facebook request to join the PT entrepreneurs, Facebook group.

You have to be a clinician. We're going to check you out. We don't just let anybody in. But if you are head there, go ahead, get signed up. We'd love to have the conversation with you in that group.

So here's the question. How do physical therapists like us who don't want to see 30 patients a day, who don't want to 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 is Danny Mattei and welcome to the PT entrepreneur podcast.

What's going on? Dr. Danny here with the PT entrepreneur podcast. And today we're talking about the hardest stage in my opinion, at least when it comes to clinical. Businesses and some people will probably think oh starting is the hardest part and I definitely would agree that starting is really hard but I feel like starting is starting your practice the heart of hardest part about starting your practice is It's the mental side It's the mental hurdles that you have to jump over to even believe that you can do something on your own.

That is actually the hardest part. Skill wise, I do not think that is the hardest part. And that's what I want to get into today. And for those of you that are listening to this and you're starting, don't discount, I'm not discounting where you're at because I totally understand what that lack of understanding, that lack of confidence is.

And just being able to try to do your own thing is a huge accomplishment. And once you do, You probably will realize, okay this isn't that challenging of a a mountain I need to climb. It's still a difficult climb. But for you to be able to replace your income, for most people with basic skills, basic understanding of sales and marketing, and there's many places you can learn that.

You can get mentorship like what we offer with something like our clinical rainmaker program. You can try to take a crack at it your own with something like the cash based field manual that I wrote. And be able to, apply those those lessons and information to your own practice, especially if it's a side hustle, because then you're not even leaving your full time job.

But when you decide to go all in the hardest stage, in my opinion, is the stage where you're growing past yourself. And here's why I say that. And if you're in that stage, I hope that if nothing else me breaking this down and letting you know legitimately why I think this is the hardest stage. I hope it makes you feel a bit better about the stage that you're in because if you can get past this stage, it's clear sailing in a lot of ways to a seven figure practice.

If that's what you want, right? If that's what you want to grow to, maybe it's less than that. Maybe it's a smaller practice. It doesn't really matter. It's clear sailing. Once you get past this stage to that size business, if that's what you decide that you want to do. So the reason why this. This stage is so hard when you go from just yourself to then growing past yourself.

Is it three things have to happen? Three very challenging things have to happen as far as like tactically tactically you're concerned and you might run a different model, but by and large is what we see most people do. So first of all, most people are going to go from a small space. With very little overhead to a standalone space where they can absorb more patient volume.

And when we look at service based businesses, like these cash based and hybrid practices, they are in person service based businesses, which means you need a place. And you need people. So you need a place for those people to actually treat other human beings. So space is needed. That means you have to go out.

You have to learn how to evaluate commercial real estate. You have to find a vetted commercial realtor. You have to understand what you're signing up for legit legally. As far as your lease is concerned, potentially finding a attorney to help you look over all that stuff and negotiate potentially.

And then you have to get with potentially a buildout team and an architect. And a contractor to build your space for the specs that you want very rewarding thing to do. Also very stressful, right? All those things you have to figure out as well as be able to understand your cash flow to be able to move into a bigger space and not put yourself in a really bad spot.

That's one. The second one is you have to bring administrative. Support on typically in a full time role, and have systems in place for them to follow so that they can effectively run an office. At this stage, you're time poor. You don't, you're treating a lot of patients, you're making good money, hopefully you're saving all that to reinvest in the growth of the business, which means people and space and equipment and things like that.

But you're very time poor. And I have to bring somebody on that. You're going to train on these administrative tasks that you are also putting a lot of trust in to be able to represent the face of the business, the front end of the business, and in a lot of ways be able to be organized, but also, do a good job of interacting with people.

So you have to have systems. That this person is running. If you haven't created systems, you have to find time to create those systems. Then you have to train this person on how to run those systems, and then you have to train them on an ongoing basis to make sure that they're doing a good job of it.

Now, once you do that, you have to do step number three, which is to hire another. Fulfiller, another clinician like yourself, which means you have to find them. You have to interview them. And then you have to understand compensation models, how to actually pay them the best way to do that. The best way in which, you can set up benefits potentially for very small business, which you know, you may not have a lot of resources to do and then you have to convince somebody that your little startup is a place where they're going to be able to work and pay their mortgage. Okay. Because what I think we don't realize, With very small practices the first hire you have is the hardest hire and the reason why the first clinical hire I should say the reason why is They don't know if they can trust you to be able to pay their student loans and their mortgage They don't know you're not a big clinic.

You don't have hundreds of locations You're not a big hospital that is far more secure in a lot of ways You're a little startup that doesn't take insurance in most cases That's sketchy. So you have to look at it from their perspective. You're going to sell them on the fact of why they want to work with you and probably do so for really no difference in, in pay or maybe less than a big clinic, but a lot more risk on their part.

So you have to convince that person. Then you have to hire them and actually bring them on, train them, make sure that they're treating people the way they. You want them to treat people, your model, the way you want them to interact with your customer experiences, and ongoing, maintain and curate that relationship so that they are being mentored and growing and feel like they are a part of a culture that is worth sticking around for.

These are all the things that you have to do while you're about as time poor as you're possibly going to get. And that's why... I say that this is the hardest stage anybody has to go through when they're building a clinic. And I see it so much now with the mastermind clients that we are working with.

Many of them, when they come in, they're in this stage. And it is tough. It is a hard stage. Some people have it easier than others. They have real fast growth. They have a pipeline of people that are coming in. They do a great job of leveraging the systems that we already have in place that they can plug and play from the mastermind.

It saves them a lot of time. And they grow very quickly. I would say that's 25% of the people on the bottom side. We have people that are like they can't find somebody to hire if they're life dependent on it, right? They're so time poor and a lot of times they're just really busy because they're, they have a full patient schedule, but they don't have time to try to go out and figure out, who they can hire and where they're at and interview these people.

And then they're just stuck, trying to grow, but not being able to put the time into anything else besides just fulfilling because they're so busy. And those people can take them a lot longer. It could, it, whereas it could take somebody, let's say three to six months to go through all of what I just explained and get up and running with another staff member on board.

I see people that'll take them 12 to 18 months on the very bottom end of that. Now in the middle 50%, it's hard, but they're usually able to do it within six to 12 months to do all that to get past themselves. And once you do that, once you have this. Physical location that's built out. And let's say you can have three or four providers that you have space to work with them in that space.

Let's, you have an office, a space for your office staff to be. You have a space that your patients come in and they're like, man, this is awesome. This looks great. This is exactly what I, where I want to, do my rehab. And from there you have. Basically fixed costs that are not going to change your overhead, your administrative staff that can support more than just yourself and another person.

And then when you add that. third person, fourth person, potentially fifth person to the practice. It's a clinician. Your fixed costs don't really change a whole lot, but your revenue increases dramatically. That means you can pour back into your people. You can pour back into your business with things like benefits and actually being able to Send them to more con ed courses and make sure that they're, doing great and be able to have more schedule flexibility with them and do team offsite stuff, and then add perks to them in the business like gym memberships or whatever it is that you want to do, that it develops the culture that you want.

You have that. You have that basic infrastructure that you need as you bring more and more people in. And that is a stage, like I said, it's clear sailing for most people from bringing that first provider on, administrative staff and and a standalone space to then another person.

It's just volume at that point, right? That comes down to new people in the door and how many people are sticking around to do ongoing recurring work with you and whatever, wherever your recurring offer is that you have damn well better have some sort of recurring offer. Cause I'm telling you the eat what you kill model where all you do is.

churn and burn. People are coming in and they're getting discharged just as fast. That's a tough game to win. And that's definitely a tough game to scale past yourself. So make sure that you understand, the model on the, not just the front end side, but also the back end recurring side of the business so that you can snowball it.

But once you have all those things in place, It's just a recruiting game. It's finding the right people and then it's curating and maintaining the relationships and the culture of your business. So if you can get past that stage and if you're in that stage, I hope this encourages you because it is hard.

And if it feels hard, yeah, it's because it is hard. It would be like, okay, if you're. If you're running a marathon and while you're in the middle of it, you're like, this is hard. This sucks. You're like, yeah, of course you're running a marathon. It sucks. That stage sucks. That stage is the equivalent of an entrepreneurial marathon to get past all the stuff that you have to do and it will take a toll on you.

But at least if you're aware of it, at least if you know that on the other side, you have basically the ability to build this little Avengers team of the best clinicians that you can possibly find, have a massive impact on your niche in your area. And. At a minimum, if you ever decided to grow past that, be able to have, 750, 000 to a million dollar plus location that is, high profit margins and creates a lot of time and financial freedom for yourself.

Is it worth it? Because if it's not, you're probably better off just staying small and not trying to go through this stage because it's hard and you might find as you try to go through it, you're like, Oh, I didn't want to do that. And then you go back to a lifestyle business and there's nothing wrong with that.

But if you want to grow past yourself, you can't skip the line on this. You have to understand that this is the dues that you'll have to pay to get to a stage where you can do that. And then if you decide you want to scale again past that, like there's a whole nother set of problems that come with it.

But. Not necessarily important for us to cover on this because for most of you if you're in this stage Don't even think about what does it mean to get three five million dollar ten million dollar whatever business? You just want to try to get past this stage and work on the right things, right?

So make sure that you're keeping your head down. Make sure you're focused on this make sure you're not trying to burn yourself out and make it happen so fast that you can't keep up because it's going to happen if you put the right work in and you're patient enough and you make the right decisions with the space and the people that you're working with.

And honestly, the space and the people you're working with is the best part. You get this amazing space that you're proud of your family can come to. They see that you're, really helping people. You have a legitimate business with a standalone location. It's funny the difference between like when I had a subways office and when I had a standalone space that was like built out, you would have thought my.

Family thought I was like, just imagining that I was in business for the first year or whatever we didn't have a standalone space and then all of a sudden they came to it and it was very real to them. It was a cool thing to see. It was great for them. They were like, Oh my God, look at this.

This is a very proud thing for them to see and it's worth it. I think it's so worth it. The people are worth it more than anything. I still go back to the, like the practice that we sold a year ago. I go back every month. I bring donuts or. Breakfast burritos or something like that to our staff and I hang out with her office manager for an hour because I like her She's amazing and I miss being in that environment because it's such a great environment to spend time in and you get a chance to do that and that's your business and You get a chance to meaningfully change people's lives with the patient work that we get to do That's awesome.

And it's worth the effort in my opinion. And if you don't feel like it is then stay small don't go through this stage and save yourself a lot of pain cause it's probably not worth it. If you don't want to really grow a culture and a team and grow past yourself. So hope this helps.

If you're in this stage. Man, hang in there. It's tough. If you need some help getting through this is a very challenging stage, probably the one that we help the most people with, especially when it comes to making sure you're finding the right space, make sure your hiring processes are good and your training systems are good.

We'd love to help you with this. This is something that we have a really good success rate with. It's easy. It's easy as going to physical therapy biz. com. Simple as that. Go check out what we do. You can learn a bit more about it. It's easy to find out how to get in touch with us from there. Great spot to learn more.

So head there. If you're interested, we'd love to help you out. If you want to do it on your own, Hey, mad respect to you. Hard to do, even harder to try to figure, but that's up to you. So as always guys, thanks so much. And I'll see you next week.

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