E792 | The New Economics of Cash-Based Practices in 2025

How Cash-Based PT Practices Are Thriving in 2025

The landscape for cash-based and hybrid physical therapy clinics has never been better. Despite economic uncertainty, patient spending remains strong, insurance continues to frustrate consumers, and more people are seeking high-quality, personalized care.

If you're running or thinking about starting a cash-based practice, here’s what you need to know about why these clinics are booming and what strategies will help you win in 2025.

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Why Cash-Based PT Clinics Are Growing (Not Struggling)

Many clinicians worry that patients won’t pay out of pocket for care. The reality? Spending on cash PT is increasing, not declining.

✅ Higher deductibles & co-pays mean patients already pay cash before insurance kicks in.
✅ Patients prefer specialized, high-quality, 1-on-1 care over rushed, high-volume clinics.
✅ More people value their health post-pandemic and see PT as a long-term investment.

The Biggest Challenge for Clinics: Hiring, Not Patient Demand

Clinics aren’t struggling with patient volume—they’re struggling to hire enough staff to meet demand. Finding qualified PTs and scaling operations efficiently is the real bottleneck.

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Economic Factors: What They Mean for PT Owners

1️⃣ Inflation & Interest Rates

📉 Inflation is stabilizing around 3%, and while interest rates remain high, they haven’t stopped clinics from expanding. If you need a loan for a build-out, expect SBA loans around 9-10% interest, but many clinics still find them worth it.

2️⃣ AI & Automation

🤖 AI is changing business operations, but hands-on PT is safe from automation. Instead, AI will eliminate redundant admin tasks, improving efficiency and profitability.

3️⃣ Patient Spending Behavior

📈 Patients are willing to pay for better care, especially when marketed correctly. People are now seeking specialized care tailored to their needs (e.g., clinics focused on runners, weightlifters, or active adults).

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5 Strategies to Grow Your Cash-Based PT Practice in 2025

1️⃣ Deliver a Premium Service (Beyond Clinical Outcomes)

📌 Being a great clinician isn’t enough. Your customer experience must be top-notch. Patients should feel valued, supported, and confident in your care.

2️⃣ Build a Strong, Niche-Focused Brand

📌 Your website, social media, and messaging should clearly communicate who you help and how you help them. The most successful clinics own a niche (e.g., runners, CrossFit athletes, or busy professionals).

3️⃣ Offer Recurring Revenue Services

📌 Stability = Growth. Clinics with at least 30% recurring revenue (e.g., memberships, performance programs, wellness services) scale faster and more predictably.

4️⃣ Leverage AI to Streamline Admin Tasks

📌 Cut costs and improve efficiency by automating scheduling, documentation, and follow-ups. Use AI tools to free up time for high-value patient interactions.

5️⃣ Focus on Health, Prevention & Performance

📌 Patients are investing in longevity, injury prevention, and overall performance more than ever. Offering long-term health solutions can set your clinic apart.

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Final Thoughts: The Future of Cash-Based PT

The cash-based PT model isn’t going anywhere—if anything, it’s becoming the preferred choice for many patients. The key to success in 2025?

✅ Market to the right audience
✅ Deliver an elite customer experience
✅ Create recurring revenue streams
✅ Use AI to reduce admin costs

At PT Biz, we’ve helped over 1,000 clinicians successfully start and scale cash-based & hybrid clinics. Want to learn how to grow your practice the right way?

📅 Schedule a Discovery Call → Click Here

🚀 Join our free PT Entrepreneur Facebook Group → Click Here

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Ready to elevate your practice? Book a call at the link below with one of our expert consultants today and start your journey to delivering unparalleled physical therapy.

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 skillset 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 Matta. 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 today my company physical therapy business helped over a thousand clinicians start growing 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? Dr. Danny here with the pt entrepreneur podcast and today we are talking about the new economics of cash based practices in 2025 so this one is going to be All about what we're seeing as far as trends are concerned with cash. And I will lump hybrid practice into this as well, because we are now working with a lot of hybrid practices in PT biz.

And what I would like to do is share. Some aggregated trends that we're seeing and by that we're actively working with hundreds of businesses all over the country in different niches and different demographic areas and different sizes. Some are smaller than others, we're working with many seven figure clinics and clinics as small as.

Just getting started, right? So any anywhere in between and when we have that kind of Information when we have that when we have that kind of size think of it like research, right? You can you know, you can have a end of one study and there could be some validity to that. There is something to be said for someone who is a subject matter expert and their expert opinion.

But when we look at the validity of research, the more people you have the bigger, the sample size, the more power the study has. And the more likely it is that the outcome of it is not by chance, right? So when we look at the hundreds of clinics that we work we work with, it's interesting to take a step back and just see what are the.

What are the trends that we're seeing? These these sort of patterns across these different clinics and and what's positive and what's negative and in 2025, I think there's a lot of, there's a lot of uncertainty for a lot of people. Um. There's there's a new there's a new government.

We're not a new government, but there's a new president. And there's there's many different changes that are occurring. And when we look at running a business, you're running a business in any political environment, like whether you like it or not that's just the way it is, you have to be adaptable and you have to understand what's happening.

And there's a lot of things you can control and a lot of things you cannot. So I'm going to talk a lot about the things that you can control, the things that we're seeing that are that are actually leading to positive growth in businesses and and really patient spending behaviors as well.

So let's start with this. Let's start with patient spending behaviors. Are we seeing people spending less money on cash at cash and hybrid clinics? And the answer is no. So when we look at. Our businesses every six months we get the the gross revenue of these clinics and we look, we actually get them every single month, but we consolidated all every six months and we look at the trailing 12 months and as we've just recently done this leading up to, we have a live event in in March and We see across the board PR after PR like so many people are having the vast majority of people their businesses are growing In a very health at a very healthy clip.

So are people spending less? No These clinics are busy if anything One of the challenges that I would say is one of the bigger challenges is hiring is being able to actually hire staff and sometimes it's a lead flow issue. Yeah, I mean like that happens for sure It's just like they don't have enough patience and this is these are always business challenges as far as marketing and sales are concerned, but for the vast majority of businesses that we work with, a lot of them, what they're struggling with is they're, if they're anything is slowing them down from scaling, it's actually that they're having a challenges staffing clinicians and and finding people that that they can hire that, that, that's a bigger bottleneck than.

They don't have enough business, which is a pretty good problem to have, if I'm being honest, I'd rather have that over not having enough business. So there's that and so what's leading to this? I think you have to look at something or you take a step back and look at the healthcare environment in general number one deductibles are up across the board like they go up all the time and it's such a frustrating thing You know, even with we're self insured obviously because we run a business and we have, insurance for our for our employees at PT biz.

And every year our our monthly payments go up, our deductible goes up. And so we have a higher deductible and higher monthly payments. And when you ask your insurance brokers, like, why is this? And they just say, that's just the way it is. It just happens every year. And it doesn't make any sense, like it makes no sense, and it's quite frustrating, right?

So if I can look at this from a consumer if I know, okay, people, until they hit their deductible they're paying cash regardless. So do you want to pay a to go work at a PT clinic where you're being seen at the same time as two or three other people and they're very generic run of the mill clinic that doesn't focus on maybe the type of, individual kind of niche that you are trying to continue to be a part of, or are you going to try to find a place that is more specific to you?

Let's say you're a runner. You're going to find a place. That works with a lot of runners and they brand themselves that way and that's how they market and they work with people in a one on one manner And they are very successful working with runners versus a corporately owned clinic or a hospital clinic where they work with all kinds of different niches and a general population Like people are becoming more informed and they're looking for more specific, Like types of clinics that match up with what they want.

So the consumer is now forced to be to have more skin in the game and they're more informed so if anything these clinics that we work with because they're doing good job in a number of other ways in terms of like really marketing to their to the right type of person that they want to work with they're having a ton of success because of the shittiness of insurance like that's it's a byproduct of a very Negative effect on everybody having to pay more money for less care as far as health insurance is concerned So the positive for us is that levels the playing field in a lot of ways when you have increased deductibles and increased co pays You know really the end is well, what's going to where are you going to get the best outcome?

Where's the best use of your time and money? And for a lot of people they're starting to find These cash and hybrid clinics are fantastic option for them. It's exactly what they're looking for, and they're not getting it somewhere else because they cannot provide that level of service and have the level of volume that they need in order to be able to have a clinic be profitable enough to be even, continue to run.

It's the reason why we're seeing so many insurance clinics reach out to us and say, We're drowning over here in poor contracts and we think there's a better way. We see these other people that seem to be doing better. How can we do the same, right? And wanting to shift their business model.

That is, in my opinion, where you're seeing with people from a spending behavior. Now, are there, is there decreased spending in other ways? economically. Yeah, you could definitely make a case for that. But when we look at these businesses in particular and people will say, Oh, these are disposable income, businesses, people don't have to go and do these things.

I don't know. I maybe if it's like pay rent or go see your P. T. Probably gonna pay rent. Most people are not in that boat and they value their health. So that is it that is an important thing for them. They're they look at it as an investment so And when we look at the analysis of patient spending, I don't see that trending down for These types of cash and hybrid clinics that are doing a really good job of marketing directly excuse me to their avatar and and now have a playing field that is far more level so let's zoom out a little bit more and let's look at the economy in general.

I hope that you don't fall asleep During this section because it is quite boring but important to understand and what we have to keep in mind is that The economy is, there's many factors that go into this and certain things can be negatively impacted and other things can be positively impacted or just insulated.

And there's two, there's three big things. Two big buzzwords in particular that I think more people are aware of than ever. One is inflation, one's tariffs, and the third one is interest rates. So let's talk about these. So inflation, if we look at inflation has been coming down, generally trending down to where the federal government wants to be at a 2% inflation rate.

Meaning the things get 2% more expensive on average each year. It's been much higher than that. And it's generally trending down and it seems to be settling in around three percent, which is higher than what the federal government would want, which is one of the reasons why interest rates have stayed high.

So if you look at interest rates, they haven't really changed much. They've gone down a little bit in the last 12 months, but they haven't changed a ton. So if you look in your neighborhood and you look at homes that are for sale, Many homes are sitting on the market for a very long period of time. And that is because a number of factors.

Number one, the payment you'll make on a home is way higher if the interest rate is 7 percent than if it was at 2 percent like it was a few years ago. The monthly payment is astronomically higher in comparison. So if somebody owns a house, and let's say they have a 2. 5 percent interest rate, they can't take that with them.

Why would they move if they could help it, right? They're going to stay in that house. They're going to They're not going to move because if they moved, they could afford a house that was far less expensive than the house that they're already in at the interest rate that they're at, and they may have equity in their house, right?

Maybe their home has gone up in value, and even if they did move and they took all that equity and they rolled it into the new house, they still are probably going to have a higher payment because interest rates are up. Now, interest rates are inversely correlated to to inflation so as in or I guess it's directly correlated put that differently meaning if inflation goes down Interest rates can come down if inflation goes up interest rates go up.

So if interest rates are high then The end result, the hope is that inflation will go down because it stops people from buying stuff. It stops people from it stalls the economy a little bit. And that in turn, it decreases inflation because people are less willing to spend on things. And if they're less willing to spend on things, then the price of things goes down.

This is part of the theory that they have, right? And obviously it's far more complex than this. But when we look at interest rates, they directly affect you. And they directly affect you as a business owner as well. So if inflation is sticking at where it's at, which is roughly 3%, interest rates are probably going to be where they are for the time being, because if they drop them, then what will happen is inflation will start to go up more.

So this is the give and take that has to happen as far as the economy is concerned with interest rates now. So what do high interest rates have to do with you aside from home prices and home mortgages? It also has to do with how much you can borrow money for as a business. And this is very applicable to us because as we go through expansion cycles in businesses and let's say you have a, let's say you have a cash or hybrid clinic and you're going through an expansion cycle, you're trying to grow into a bigger space, more equipment, more offices, maybe you go in from a place where you, it's you and two other clinicians you want to build into a place where you can have six clinicians.

So it's maybe twice the size. Let's say you want to take out 100, 000 loan to expand, right? That 100, 000 loan, if we look at an SBA loan right now, currently as of February 13th I'm recording this. That's going to be about nine and a half percent interest on an SBA expansion loan. So that's the prime rate plus a couple of percent.

So that's a decent amount of interest. If we, if you really look at it is it so high that it's cost prohibitive for a business to be able to expand? It's not. Like we see people make these work all the time, these are spread out over extended periods of time So this if you look at a sba expansion loan, it's like a 10 year term And right now it's like a nine and a half percent interest rate.

So You know that payment on that is like 12 1300 bucks if you're expanding and you need 100 grand to be able to Buy equipment and bolster some cash reserves and maybe help with finishing out a build out. Does that 12, 13, 1, 300 payment stop you from doing it in order to invest in the business?

Probably not. But if it was 5%, 6%, then it would be even lower than that. You're talking about a couple hundred dollar difference per month could make a meaningful difference. So these are things that are in some ways stalling progress of growth, but they're not so high that it's really stopping people that are having success in their business.

Like we're going to find a way to grow. And if that means. Okay. We had pay a little bit more in interest. We maybe have slightly lower profitability during that time, which we're paying it off, then that's really not enough to stop people from from making those jumps. And we see it all the time.

Like we have businesses every single month that are going, getting these exact loans and they're growing their businesses successfully. The last thing is tariffs and tariffs are interesting because they're not. They're nothing new. These are actually been around for a long time and we've had tariffs on plenty of different products that come into the country.

But the fear of these in particular is I think what what is challenged a lot of a lot of consumers. They don't know what to expect and the unknown causes stress and it causes people to Second guess their buying behaviors And no doubt that will have it will have an effect because they are inflationary in the short term for sure.

So If we see that this actually happens and we don't know exactly what's gonna happen as far as tariffs are concerned, and what countries and what goods they, they can make exceptions for many different things. But let's say that that we do have increased tariffs that will increase inflation in the short term at a minimum.

And it's because the consumer will then get the tariff passed through to them in most cases. It's not like the company is just going to eat it, or maybe they do a portion of it, but not all of it, obviously. That causes some inflation as well. That might go up in the short term, that might stay the same in the short term.

Either way, right now we're sitting at about 3%, and I assume it's probably going to be somewhere in that neighborhood. I don't know if we'll get down to 2%. If we do great interest rates come down. And if we don't, then they stay roughly where they're at. So from a housing market standpoint, that's a bit problematic.

But from a business owner standpoint and expansion and getting getting loans there, they're readily available and the interest rates are not so high that it's going to stop you from being able to being able to actually grow. Your business. In fact, it seems like a really good time to really be able to expand your business.

And here's why I say that even though it may be more expensive to borrow money, we're seeing real wages improve. Real wages are inflation adjusted income essentially, right? So let's say you make 80, 000. Real wages are like, if you were to say, I make 80, 000, the buying power of that equates to this, right?

Versus what did that equate to five years ago? And what we saw is real wages took a dip post COVID because of a number of factors we had, things became a lot more expensive, but real wages are starting to improve. Now people are getting, are are making more money. They're getting raises and inflation is relatively low.

In comparison, so they're seeing their real wages go up. That means that they have more disposable income Than they did even two years ago, right? And even two years ago, we're still seeing these businesses grow, right? That is the interesting thing about these these clinics they seem to be quite resistant to economic changes and much more so than, for instance, like my friend he works a lot within the restaurant industry.

He's in wine sales and 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 more clinicians 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. Restaurants, especially higher end restaurants, have really been struggling the last couple years because that is a not a necessary thing, right? But if you look at your body as an investment, then you're going to prioritize setting money aside for that, especially if you have a massive deductible and a super high copay.

So if you're in pain, you're going to go get something addressed regardless. And now you have this option between, a smaller more niche focused clinic that, that, that works more specifically people like yourself, or you go to a general clinic, maybe they take your insurance, but you have a 5, 000 deductible.

You're out of pocket. Hey, the only way you win is if you hit it and you have to have surgery enough to pay for that. And that's not a win for most people, right? So real wages are improving and that's a very positive thing. For really any business, but especially, for arts, people are making more money and they can afford more things because of what they're making and can buy them more.

So when we look at strategies to win in 2025 and actually, let me take a step back because I do want to talk about one other thing. And that would be the. The fast growth of artificial intelligence, and I'm not gonna talk about this too much because it's a massive topic.

But when we look at a. I. Is one of those things that for a lot of people, what's interesting is there are there is going to be. Some economic challenges associated with it. And there's also going to be a lot of economic benefit. The thing that seems to be most Capable of replacing right now is administrative tasks redundant administrative tasks So if you are an administrative job That could be very challenging for you.

If you're a physical therapist and you're doing hands on work with people face to face, you're quite insulated from that. So when we look at what could potentially be a negative for some industries, some jobs that people might need to reskill and they might lose their job. Physical therapy is not one of them.

And people are going to value face to face human interactions more and more. You know over the next few decades, especially as we become more and more Virtual and live in more of a digitized world, which is already happening So, that's a big thing to keep an eye on not necessarily As how does this affect you, and your ability to see patients?

It doesn't necessarily as far as that's concerned but when we look at the mundane administrative things that maybe you are doing in your own clinic Those are things that I think will be able to be offset with relatively inexpensive AI applications that are going to make it to where you can focus more on the person in front of you and less on the administrative side of things, or maybe for you you increase net profitability because you don't need as many as administrative people within your business because you can have.

technology step in at a fraction of the cost and be able to take care of whatever that administrative task is. So these are things that I think are very positive things for the PT profession going forward. So when we look at strategies to win number one, you got to have an amazing service.

This is just, this should literally be a check the box. I'm not just saying outcomes. Yes. You need to be a great clinician. We want you to be a fantastic clinician. But That's, that should check the box. You should be a fantastic clinician if you open your own clinic. If you're a terrible clinician, you open a clinic, like it's not gonna go very well.

And don't just bank on that. Don't just think to yourself, man, I'm just such a great clinician that I'm never gonna have to worry about my business ever again. That's, you're like, don't take us the wrong way. There's great clinicians all over the place. You need to have great clinical outcomes along with a fantastic service, customer experience, the way people feel about your business.

It means so much more than you may even think. And it means a lot in terms of their likelihood of referring somebody to then work with you, which is the. Greatest form of marketing because it's free to you and they're the most likely to convert people, the least price sensitive people. And more of the folks that you just crush it with, right?

So you have to go above and beyond. You have to really focus on your customer experience and how people feel when they interact with your brand, not necessarily the outcomes they get when you interact with your brand. And this is something when I talk to clinicians that are just like, they're like clinical purists, right?

It's their clinical work is an art to them. And, they're just fantastic with clinical outcomes and just really good clinicians. They don't see as much of a emphasis needed to be put on the client experience as the clinical outcomes that they're getting, which you need both.

But if you're just this fantastic clinician, and, you're a Jedi of a clinician, that's great. But I can promise you this, if somebody is not as good as you but yet their business creates a fantastic client experience you're probably not going to get as many referrals as that business.

You get, you need to have both. You need to realize that you're competing with other people, not just on outcomes, but also on. The brand, the business and how people feel when they interact with your business and the way people feel about your business actually dictates more of whether somebody is going to refer to you or not, it's not your outcomes, which is ironic, right?

You would think it would just be that it's actually it's partially outcomes, but it's more heavily. experience. Did they have a fantastic time over there? Do they feel very taken care of? They feel, special. Those are the things that actually make a really big difference. The other big thing is your brand.

So focusing on your brand and in particular, um, the avatar that you're trying to really work with, right? So we'll use this runner's example. So if you look at your brand, If somebody goes to your social media, accounts, if they go to your website, um, do, is it clear to them who you work with pretty quickly, right?

If you want to work with runners and yet you have nothing but pictures of people doing yoga poses, it's going to be confusing to them. If, if you want to work with runners and all you do is have pictures of people that are doing like Olympic lifts. Probably gonna be confusing, but if you work with runners and you have, education articles and videos specifically on all these running specific injuries and running specific training and Exercises and all kinds of stuff if you have case studies of runners if you're showing up at local running events like Your brand has to represent who you're trying to be the go to person for in your area.

I'm not saying you can't be a generalist, because that will happen, but you have to dominate your niche. You have to focus on your niche, and you're still going to get general people around that. I noticed this when we started our clinic. I really focused on the CrossFit community. I was just like, the go to CrossFit person in Atlanta was what I wanted to be.

And what was funny was the first few people that I got that were not CrossFit athletes they were referrals, and the people that referred them, they asked me before they connected me with, this other person, they're like, hey do you work with people that are not CrossFitters? My, my brother's like trying to run a 5K and he's got whatever, some foot pain.

And I'm like, yeah, dude, absolutely. But it done such a good job of focusing on CrossFit. They weren't sure. Maybe for you it's communicating with your patients that you do see other people, but you still want your marketing. You want your brand to be focused on something that allows people to understand who you're, world class with.

And that is, that's going to be much easier for you to win that than it is for you to just be like, General a general clinic. I think that's a tough one to win unless you have a lot of marketing resources You have a you have a big brand you have a lot of capital to invest in your brand And advertising in particular so really focusing on a strong brand, your logo your colors your the way that you brand Your your posts and having them be consistent.

These are all really important to develop a strong brand that people resonate with. The next thing I would say from a strategy to win is to focus on prevention and health and performance. So this is a trend. This is really coming out of 2020 with a lot of people.

With COVID they the biggest silver lining I see from. From a global pandemic is the fact that people took a step back and really looked at their health and they realized like, Oh shit, viruses kill people that are less healthy, period, right? You can't change your age necessarily, and it definitely affected older people, but you can definitely affect your biological Age.

If that's the right way now, you're right. Your health internally, right? Maybe you're 50, but you're as healthy as like the average 35 year old. So you can affect that and you can invest in your health. You can invest in performance and prevention and health and wellness.

And a lot of people are looking to do that. They want to do that. I think the other thing that you're seeing is a lot of people are realizing they're going to live longer than they think, like the average person that invest in their health somewhat is going to live longer than they probably thought they would have 10 years ago.

And they want to be able to use their vehicle in life to get around for the time that they're going to have. So that means strength, flexibility, endurance coordination, all these things that people are going to need in order to navigate the world. They want to work on that and there's been a big push to really focus on health.

All you have to do is look at the, the different movements that are out there in the the tech space. So tech in particular, it leads the way of a lot of trends. And I went to the HubSpot conference, not last year, but the year before. And I was really shocked that Andrew Huberman was the keynote presenter.

And it's shocking to me that people listen to a three or four hour podcast on, ocular neuroscience that, that are not researchers but hey, they do so awesome. And that is a trend that I see continuing. And there's a trend out there as a guy, his name is Brian Johnson and he has a movement.

It's called the don't die movement. And he's convinced that he's going to stop the aging process. And he's a very wealthy, he sold a company, I think he sold Venmo or brain tree, one of these payment processors. And he's dumped like millions and millions of dollars into basically trying to figure out how he can stop the aging process.

And it's it's extreme as fuck by the way, it's like super extreme. But my point with this is That people are turning their attention towards longevity towards health towards wellness. I'm sure you see this yourself and you can be a part of that if you have You know the knowledge to be a part of that and the interest to be a part of that But that is a fantastic element of your business.

That is that is very recurring. There's very ongoing And it helps people really, live longer, but also squeeze every little bit of life juice of the life that they have out as they can, because this is how we get around the world. This is our vehicle. And being able to have conversations with people about that, being able to understand what their goals are as a unique place to be as a performance based clinician that people are looking for.

And if you can provide that, I think that is a fantastic revenue stream, a fantastic. Insulated ongoing continuity offer that you can be a part of this. You're really stabilize your business. And that brings me to my last point, which is really developing and maintaining high levels of continuity or recurring revenue in your business.

We're finding that if businesses are not at 30%. Recurring, which is on the low end 30% recurring or reoccurring revenue and services they really struggle to be able to grow. One of our one of our friends, Jeremy DuPont, owns a marketing company called Patch, which is fantastic. And they do a lot of, they do a lot of work with businesses all over the US and right now they work with a couple hundred clinics helping really as their fractional CMO doing.

Email marketing and running ads and newsletters and quarterly remarketing campaigns and stuff like that. And they benchmark some of the stuff as well. And what they're finding is the clinics that are doing the best, especially when it comes to ROI on ads because you're looking at lifetime value are, if you can be at 60 percent recurring people that are coming in are sticking around to do some sort of recurring, you are just like on, you basically are on a rocket ship.

To grow that clinic to whatever size it is that you want, because if you do the math on this let's say it costs you. 200 to get a patient in the door for an evaluation, and, but that patient is worth 6, 000 lifetime value. That is a massive ratio right there, right?

So you look at your cost to acquire. Or your CAC, which is 200 in this scenario, and your lifetime value. You divide your lifetime value by your cost to acquire, and you have your ratio there, right? That's a very high ratio, because would you pay 200 to then add 6, 000 of lifetime value to your business?

Most people would probably take that, right? All day. If they can do basic math, they realize this is a fantastic ROI. But let's say you're not doing well on continuity. You're not giving people a reason to stick around. You're running more of a traditional, I solved your problem that you're discharged model.

Now all of a sudden, maybe your lifetime value is 2, 000, right? So your ratio is a 10 in that scenario, if it's 200 to get them in and 2, 000 still high, that's still pretty damn good, but it's definitely not nearly as good as 6, 000 if you're doing a good job of keeping people around. So that's what you got to keep in mind is the stability you get from that.

allows you to grow more, allows you to advertise more, but it also allows you to predict your your revenue so much better your growth, your your hiring, like everything that you're going to do is more predictable and you're not necessarily just going out and it's like you have to kill something every single month so everybody can eat.

You have a recurring stable revenue that allows you to to focus on less than just, acquisition. And that's a really solid place to be. And honestly, if we're looking at like the value of businesses, nobody's going to buy a business that has.

No recurring revenue, like it's just not as valuable. It's not as stable. You really have to look at that for a number of factors, but having and developing some variation of continuity offers is a massive thing to focus on in 2025. So in summary, let me go through these strategies to win.

Cause these are the big things. That I want you to focus on. And actually let's start from the beginning. Number one patient spending behaviors are not going down. We're seeing these clinics have PR months, month after month. They're growing. Their biggest problem is staffing in many cases.

Now there's obviously clinics that are maybe having a harder time than others. But if we were to look at the average across the board of the clinics, we're working with they're all growing quite well. And I'm not seeing any patient spending behaviors dropping off a cliff the way that people might think that they are there.

They're not that you got inflation tariffs and interest rates. These are going to affect the broader economy, but you as a business owner. What this to me, it shows is, yeah, you're gonna have to deal with a little bit higher interest rates if you're borrowing money, but it's not so high that it's essentially cost prohibitive for you to be able to grow your clinic.

You're still able to grow your clinic because you can manage a higher interest rate. And there's still great loan vehicles out there if you need to borrow money in order to reinvest in the business to be able to expand and grow. We look at strategies to win. You've got to develop a strong brand.

So make sure that you have consistency with your brand. Make sure you're focusing on trying to win with us, with a certain avatar niche group deliver an amazing service, not just the outcome, but also the customer experience, make people feel special, do things that are unique to them. Build a culture around your clinic.

That's fun and in a place that people want to be in and they want to send their friends and family focus on performance, prevention and health, and really developing that into continuity offers to help stabilize your clinic. People are looking for people to help them live a high performance, pain free life for as long as possible.

If you can fall into a category of someone that does that in your area, you're going to have. More business than you know what to do with and those people are going to stick around for extended periods of time This is a trend that's happening. It's a trend that's happening and lots of other adjacent Industries, but we are subject matter experts when it comes to this stuff.

It's a great place for you continue to learn as well You know, it's like you don't know anything about Sleep and sleep improvements and cool. What a great opportunity to learn if you don't know anything about blood panels and what that means for people and some basic nutrition and and how you can help affect people in a long term that way.

Great. Perfect opportunity to learn. If you don't know how to program for people to help them achieve long term, strain conditioning changes and improve their their conditioning and their energy systems and focusing towards a goal. Fantastic. Great opportunity to learn, right?

All these things are just opportunities for you to learn. To become better, more well rounded and not just be somebody that can help somebody solve a pain problem. You want to be able to help them live and really experience the world physically as, as long as they possibly can.

And at the highest level, they possibly can. And people are looking for that. And if you can do that, you're going to have no problems whatsoever growing in 2025. This is in my opinion, the path to really securing your business in a manner that you have consistent growth. And.

Ignore the noise, ignore the shit that you hear, about the economy, this, that, whatever, focus on your business. There's plenty of things you can't control. I'm telling you we're in a pretty good spot generally, as far as these businesses go there may be some. There may be some economic challenges that we have to deal with.

And and that's okay. That's normal. It happens. There's ups and downs in economies for, as long as you've had them. You can't change that. You can focus on are the things that I just talked about. And if you can control those and focus on those, you're going to be in just, a fantastic spot for your business.

I see a lot of growth in 2025 for businesses like this. And honestly, for decades to come, I'm very bullish on these clinics. Even more so than when I started mine. I think the landscape is now is even better than it was 10 years ago. It's definitely way better than it was 10 years ago.

It was so hard to even convince somebody to come in because they just thought I was an asshole for not taking their insurance. And now everybody realizes that insurances are the assholes. And we just don't want to play their game. So anyway, that's all I got for you. Hope you liked this one as always.

Thanks so much for listening. Catch you next time.

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