E196 | 3 Barriers To Starting A Cash-Based Practice

What I discuss in today's podcast episode are the top 3 reasons I see people drag their feet on deciding to start their own cash-based practice.  If you are interested in learning more about starting a practice head to https://www.physicaltherapybiz.com/masterclass.  This training includes my 5 step process that I use to start practices in almost any niche.

Episode Transcription:

Hey, what's going on, guys? Doc Danny here with the PT Entrepreneur Podcast, and I'm excited to talk to you today. If you have been thinking about starting a cash-based practice if you're a student, maybe, and a, you think this is what you want to do whenever you get out. You want to, do your own thing, whether it be performance managers like us, golf, tennis, gymnastics, women's health, any number of niches within that, that type of practice. You're going to like this podcast today because what I want to talk to you about is the top three reasons that I see or excuses. Let me put it that way. I might offend some people as I started talking about excuses, but these are excuses that I hear from people about why they drag their feet or decide not to do something on their own.

And you know, this sort of stems from the training that I did Last week it was part of our, our blueprint program. And part of that with some live mindset training. We were going over and I just, I, I've been working. A lot more with business owners that already own practices that are trying to scale past only themselves.

So to where they have another staff provider and administrative staff member and then, and be able to build an infrastructure of a business to scale to multiple staff members within their cash-based practice and much less with people that were, that are just getting started. And previously over the last, I would say, two years, I've helped a couple of hundred people get started.

And, I forget just how scared or how scary it can be too, initially, initially start a business. And now I think we're just sort of comfortable with the discomfort associated with owning a business and some of the unknown that goes along with that. But, You know, on this call, I realize that.

There's, there are some things that, that are there that everybody goes through and experiences and there's normal, you know? So, I want to talk about a few of those. And, for those of you that are interested in this topic, if you're going to take a deeper dive into this stuff. I would encourage you to go to physicaltherapybiz.com forward slash masterclass.

There's free training there. It's just on-demand training. I'm on, the sort of five-step process that I use to, start practices in really any niche and the things that you really just need to know and get right from the, from the get-go to make sure that you don't, What you don't put yourself in a wrong position from the beginning of your business. So that's free. It's on-demand. You can watch it whenever you want. Physical therapy, biz.com forward slash masterclass, so let's get into these three areas. And I sort of alluded to the first one, I guess already.

And that is the mindset. So the mindset's interesting. It's sort of a, I guess it can mean something different to everybody, but really to me, it boils down to just confidence. I mean, I think that's probably the simplest way to explain mindset in terms of how I look at it. And I look at it, from the lens of business because I've, I've been in it now at this point, for five years between our cash-based practice in and the other company that we own.

And, but I also can see it from the standpoint that maybe many of you can, can also, you know, have experienced. To, to share, which would be like athletics, right? So, you know, for me, I played a lot of baseball growing up. That was sort of my, you know, my, the sport that I played the most. And you know, baseball is an exciting sport because it's very individual.

And yet you're on a team, but when somebody hits you a ground ball, if that ball goes between your legs, that's your fault. You know, he can't blame anybody else. And it's very, and it's a very apparent whose error that is. If you strike out, you struck out, you know, you can't blame anybody else. It's your fault.

So I think that you know when you look at something like that. Confidence is an essential element to some, and in my experience, baseball. And you know, you can take any number of sports that, that you're, that you're in. I mean, the mindset that we have competing for dictates how we're going to do tremendously.

And we all know people that are like, practice all-stars, and then they just shut down in a game situation. But, but if you think about it. The skill sets no different. You know, if the skill sets, they're in practice. Why is this skill set not there in a game? And there are some people that they're sort of like loafers in, practice.

They kind of, they don't do all that while I'm practicing going to trial that hard. But man, when it's game time, they like to flip a switch, and they're. They're just better. They're gamers, you know? And that is the mindset. It's not a skillset, and it's a mindset. And you can train these skills all we want, but the mental side of it is so important, and it's very natural to be fearful of starting something new.

And we probably, you know, for, for me, I felt this way. I think every time I graduated to another school, like when I went from elementary school to middle school, I was like, damn, it's going to be hard. I don't know if I'm going to make it through, though, as I'm the, you know, like those courses are going to be harder from middle school to high school.

Same thing. High school to college. Definitely. I thought. I was like, all right, Danny, you got to get your shit together. You're in college now. It's time for you to start paying attention and not falling out of school like this is, this means something. This isn't a middle school or high school. And then, when I got to a PT school, I had the same thing.

I was like, all right, time to time to focus in and you know, get your shit together, man. You can't, and you can't screw this up. This is important. And you know, when you look at this for me. I hadn't really, and I'd never failed anything. So why did I have this, this approach of, you know, feeling like I've always was going not to make it right?

Well, that was a mindset issue, and it was a poor mindset. Overall, when in actuality, there wasn't any fear associated that, like for me I, I knew I would do what I needed to do to put the time in to study or to, you know, put the projects together that I needed to. And, And, and, and be able to learn the skills.

Like I, that wasn't the issue. It was just a new environment. And the new environment was, w was what I was more afraid of than anything else. So I can tell you the same thing that happened to me. The same thing happened to me when I went into the army and when I left the military. Now when I went into the Army, that's a whole different place, like anybody that's been in the military can probably attest to the fact that the army is a unique environment where You're, you're treated differently. Not necessarily in the wrong way, but it's different. There's a chain of command, you know, there's, there are a customs that that is there and courtesies that you have to follow.

And if you don't, it's very; it's very okay to yell at somebody in the military. That's probably the best thing it is like, you could, I'd be able to people in the military, and it's fantastic. It's like, I know you got somebody you probably want to just yell at, you know, in your, whatever, in your workforce, some of your work with.

Maybe you can do that in the military. It's awesome. You can't be necessary that civilian wise to get you probably sued or, you know, somebody is going to hurt their feelings, and then they're going to leave and whatever. It could be bad for you. So anyway, hold that in. But my point is that the environment was very, very, I had a lot of anxiety going into the military because of a difference in mine.

A situation. I was in the, is this a different position? A different environment, a diverse group of people. And the same thing happened. I got out of the military, and I started my business. I didn't know what to expect. And I think that this is what holds most of you back more than anything. This is the number one thing.

The fear of the unknown. You don't know what to expect. You have nothing to relate to this. You know you unless you've started another business on your own, there's no way for you too prep yourself in a manner that's going to. Set you up for success in the store except for just diving into it. You know, that's about all you can do to start.

You can read as many books as you want. You can listen to as many of these podcasts as you wish, but it's scary no matter what, no matter who you are. But the mindset of this, the fear of this primarily comes down to the dismay of rejection and failure. Now, I'm going to say that again because I think that's.

For some of you, you may be sitting there while you're driving to work, and you're like, that's spot on. It's precisely what most people are afraid of. It's failure and rejection in particular. Failure and the way that that is perceived by everybody else around you. For me, the biggest fear that I had besides not being able to, you know, make enough money to support my family, which is a bit irrational because I could always go back and get like a PRN job that I hated or work home health very quickly.

I wouldn't have put us, you know, whatever on the streets. And that's what we tend to think. But. I could have done that very, very quickly. It wasn't the fear of that, and I knew I could get, you know, a job and make good money just with a degree that I had. Maybe it wouldn't be the thing that I loved, but I could still do it, and I would do it if I needed to, but it was the fear of failure and what that looked like to my friends and family.

I thought. The thing that I would have, put off doing the longest I would have done everything possible not to have to do this would be to have to go shut down my business and go work for somebody else. And it's silly to think that that creates so much fear because you know what, Michael Jordan famously said, like, you miss 100% of the shots you don't take.

And that's true. You know, like. You don't know what's going to happen whenever you bet on yourself, but it's the fear of you having to go back then and then everybody realizing like, Oh, you failed at this. This isn't this. Well, I'd say what? I would rather fail and have to learn a lesson from that and then go back and, and you know, take a position that maybe I didn't want then not even try to begin with.

You, and I think if you reframe it and look at it differently, you might come to a different conclusion about really how much fear is associated with that. Is there a fear associated with that, or did you try to do something more than what most people ever do from a career standpoint in, in, in their life?

And very, very few people will try to do something on their own because there's fear associated with it. And it's fear of rejection as well. What if, what if people don't want to work with you? You know, like if you go to a clinic and you're a staff, a practitioner, you don't really, you're very insulated from this.
You show up; there are patients on your schedule, you do your job, you go home. That's it. You don't have that rejection associated with going and trying to develop a relationship with somebody that doesn't want anything to do with you. You know, or talking to somebody that you know, you can help, and they're not interested in working with you.

Do you know? Maybe it's a. I don't know; several factors could be a reason, reason why, but just the rejection of that, the denial of somebody saying no is fearful, and it's something that stops people from actually doing something on, on their own. So the mindset side of it, the fear and dealing with that is, it's essential to understand that.

And I, from what I've found when you can start to be a little bit more self-aware. Of why you're fearful of that, and then understand that that fear is not a bad thing. It's very reasonable. It's very healthy. You know, like it is deep-rooted. There's a reason why people are scared of Heights because the people that weren't scared of Heights died, and their genetics didn't live on very well.

And the people that we're scared of Heights didn't die. And guess what? They are alive, and there are ancestors, and that's how it works. So when you look at some of these fears, some of this is like going out on your own. Is it sort of leaving the tribe a little bit, right? Like you're alienating yourself in some way.

It's natural to have a fear of that. Look, we're not going to wander off into the woods and be eaten by a saber-tooth tiger for God's sakes. You're opening a business, and there are different ways to do it and kind of talk about this and the next, in the next bullet point. But, You know, that's where this fear comes from.

And the more you can associate where it comes from and why it's healthy, the less scary it feels. And the more likely it is that you can push past that and do the thing that you know you want to do. Do you know? And if a little bit of fear stops you from doing it, you're going to have a lot of regrets associated with that along the way.

So number two, student loans. Look, student loans are a real problem. I think it's a massive, massive problem. In the US, the amount of money that we come out with, with student loans, is crazy. And some of it also, let's be honest, guys, some of this is self-induced. Okay? So some of it did you have to go to that super expensive private undergrad, you know, like, could you have gone to a state school maybe and had, a quarter of the number of student loans?

Probably, but you know what, you're 18 years old and. You didn't maybe look at the longterm implications of that. You knew you wanted to go to this cool school and, and you rack up a bunch of loans. In the process. Same thing with you, with your graduate program. So maybe, you know, the school you got into was out of state, but it was an excellent program.

And at the time you thought yourself, man, it's going to be worth it. The alumni association, maybe it is, you know, but when you're, when you're sitting $200,000 in debt, you know, and on the high end, the highest I've ever heard was $380,000. If any of you are higher than that, you don't even have to let me know.
Like that's, that's just, that's rough. I feel bad for you with that. I mean, that's a beautiful house that you just paid for basically. And. You know, that's a scary amount of debt. Even if you know you could have $20,000 in student loans; still, that's a lot of money. If that amount of funds were sitting on a table in front of you in like the twenties, you'd be like, damn, this is a lot of money.

So you know, for you understand that these are real problems that a lot of people deal with, not just our profession. Really. Anybody that's going to school now is racking up a lot of student loans and especially graduate, graduate degrees. So when you look at your student loans, you have the monthly payment that you have to pay, and you can't get away from that.

And, the fact that you, you know, you can't default from those loans, there's the only, like one of them, one of the only ones, if not the only one, you can't default from. That's pretty nuts. When, when we think about it, you know, you're, you're stuck with that forever. So here's my advice with this stuff.

If student loans are the reason why you are deciding not to, take a chance on yourself with a; with a cash-based practice, I recommend that you think about what it's going to cost and what the return on investment can be for you in particular with a side hustle practice. Now, for those of you that are.

Are unfamiliar with these different variations of how to start a practice. I recommend that you go to F insurancebook.com; if you haven't already gotten the book, get the book that I wrote is called fuck insurance, and it's your playbook to a performance-based cash-based practice and never having to deal with insurance again.

Now in that. Book. I referenced two different variations of how to start a practice. And one of those is a side hustle. So if you haven't gotten the book, had to F insurance, book.com, and you can get it for free. I've got to do pay for shipping for me to send it to you, and you got it. Now, here's what I want to talk about with this.

So a side hustle practice. When I started my practice, I started for less than $3,000. And at this point, that practice has generated. Like, well over a million dollars in gross revenue. Okay, so what's the return on investment for that? It's a ton. I don't know what the difference is. More than any stock you can invest in.

And I hear people say, say this stuff all the time, I'm like, well, I'm not going to be contributing to my 401k. Your 401k can't even come close to matching what you put in your own time and money into a business can generate like what? What. Four Oh one, what stock? What 401k mutual fund can you put $3,000 into and then have something within five years that's generating hundreds of thousands of dollars a year for that $3,000 investment?

Like, I know of nothing. That that you can invest in like that besides your own business and adding your own, or spending your own time into that, right? So if you are a student with a, with a lot of loans, if you can start a practice, and for me, that was $3,000 that was, and I bought a computer with that too, by the way.

So maybe you already have a computer, you could probably do it for less than 2000 so here's my point with this is if you can take it—a relatively small amount of money to start something on the side without Lou leaving your job. Or maybe you, you do go your job, and you take a different position than pays more in terms of like hourly or total compensation.

Maybe you don't like it as much, but you don't necessarily want to be there forever, but take that other position and then start your practice on the side and a side hustle manner and start to generate a secondary stream of revenue. With your side practice. Now this is the debate that I tend to get into people with student loans.
Cause I, I mean, we had student loans from undergrad. I didn't have student loans from, from Baylor because it's a, it's a military scholarship program. Right. So like I got gotta, I got accepted into the program, and then, I owed the army four and a half years of active duty service afterward. So, you know, I didn't have any student loans associated that, but undergrad, we did.

And you know, when we paid those off. You see, we did it by primarily just not spending much money and putting as much as we could towards our student loans. And that's very, that's one great way to do it. If you want to be, very, very strict with how you spend money, you can do that, and you can do it in a manner that can, can pay your student loans off quickly and get that weight off of you.

But now imagine this, imagine if you did that. And you were very frugal, and you know, you stuck to trying to pay these off as fast as you could. And along the way, you started a side business that started generating anywhere between a thousand and maybe four or $5,000 a month in revenue for you, plus the actual income that you're still making, working your full-time job.

Now you're working your ass off. Don't get me wrong, but could you work your butt off for a year or two and. Completely get rid of your student loans. Oh. And then have a business that you can grow into something much, much more significant along the way. Yeah, that sounds like a pretty good way to go about it, because even if you just took, you know, an extra thousand dollars you could make on a side hustle practice, which is very, very doable.

I see people do it all the time. That extra thousand dollars added towards your student loans help pay them down much, much faster. So I think that we have to look at is. If that's what's holding you back, that might be one of the main reasons why you would want to start something like this so that you can make more money.

Take that money, don't spend it, but put it towards. Paying your student loans down, and then you don't have this payment anymore, your cashflow. Now this, this is what really, this is where wealth accumulation accelerates. It's when you start to have fiscal responsibility with how you're spending your money.

You're taking. The excess money that you have, which hopefully is a decent percentage of what you're bringing in, and you're putting that towards debt to pay that debt down. Now, what happens when all that debt has been paid off? Well, now you have this additional. Amount of money that you're not used to spending, that you can then start to leverage into lots of other investments, and it doesn't affect your, your quality of life at all because you're not used to having it in the first place.

It's, it's the best approach. And now, once you get to that point. Then it's like, okay, well, I can reinvest in my business. I can take that money each month, and I can reinvest in whatever it is that you want to do. Business information, education, marketing, all kinds of things, con-ed, and your skillset. You know, plenty of different places where you can invest in yourself, in your, in your business.

Maybe it's. A rental house, perhaps you want to buy a home, and you want to go, you know, the real estate routes and develop, you know, some diversification within, you know, your wealth and, have passive revenue or at least a secondary stream of income associated with that. You know, maybe it's investing in some sort of, you know, retirement vehicle instead, and you can throw a lot more money at it a lot faster whenever you have this.

This extra money that you're not used to spending cause you've been putting it towards loans all the time. So I look at a side hustle practice as an excellent way of starting to generate more money and putting that money towards the thing that you know is just crushing you inside, which is the student loan.

A debt that you can't get away from. So if that's holding you back, maybe reframe it and think about, well, what could happen if I did do this successfully? I believe that you could pay your student debt, your student loans off much faster. And I've seen it over and over again within people that are in our blueprint program and our mastermind, you know, I'm talking 60 to $100,000 in debt if people are paying off within like two years, just by making the same approach.

So. Keep that in mind. If student loans are holding you back, think about it differently now; the last one, number three, is not knowing how the sausage gets made. So this is a, I hadn't heard this phrase. My wife loves this phrase cause it's from like. A song in Hamilton, the musical Hamilton, which, which I took her to, and here's awesome Atlanta by the way.

But, anyway, the sausage is getting made. They don't understand, like how does it happen? And the fear of not necessarily knowing how everything works stops them from. Initiating or getting started with their own, with their private practice. And, and a lot of this is, is basic stuff. So, insurance, how do you deal with it?

You know what, what do you need to do or not need to do? Superbills, what the hell is that thing? Who gets it? Who doesn't practice acts, you know, what is your say? Who do you talk to? What kind of legal counsel do you need new patients? Where the heck does, where do you get him from? How do people find you?

You know, how do you deal with this person that comes through the door? What happens if they don't get better? What happens if they do get better sales? You know, how do you get them to commit to you to solve a problem and commit to a plan of care? You know, how do all these things work as well as many, many other things?

What things should you track? You know, what does a healthy business look like? When do you reinvest in your business? When do you hire administrative staff? When you hire a team, you know, practitioners, you know, what's the best location? What's the sublease look like? There's a lot of stuff that is associated with it.

You know, you have been able to start this thing up in a manner where it can be successful, and there's information out there. I mean, that's, this is the other thing is like, there's information, there's a lot of content, and I think that the material is not the problem. It's context to the content.

So organization of that is the whole reason why, you know, people end up purchasing the blueprint program that we have, because it's, Hey, step one, two, three, four, there's what you do. These are the resources. These are the everyday things that we see. And it gives people context. So alignment of the information.

So if this stuff is, it is something that is one of the primary reasons that you're not starting. You can learn this stuff. Now, if you don't want the organize information, something like the blueprint, you can figure this stuff out via blogs, you know, podcast via, you know, videos online, all kinds of material, and get going.

You know, I didn't have a digital program that showed me how to start a practice. Sure. So I wish there was one that was around when I began training, cause I had to learn all this crap. You know, the hard way. And in many cases, I did things wrong to start with. And then I had a costume mistake associated with it.

And, I mean, I've had tons of mistakes that I've made that just, I didn't know existed because there wasn't a lot of information about the business model out there. But now there is, you know, and it's relatively. A lot of it's free, and a lot of is relatively inexpensive based on, you know, your investment within your business and what you can expect as a return on that.

So if you're struggling with this section of it, this is probably the part that is the easiest to solve. You know, the information is out there. The hardest, in my opinion, is the first one is the mindset side of things is the, is the—confidence associated with knowing that you have the skillset to be successful.

That is challenging. You know, that's hard. And it's the only, only way to get over that is to put yourself in the arena, is to put yourself in the position to have to, you know. See people have to get turned down by, people have to get rejected, you know, have to, learn and learn the, on the fly and, and, not maybe know exactly what's going to come next.

And that's extremely challenging for people. It's, it's challenging for me to this day because. Things change so much. I mean, business changes quickly now more so than it did make 50 to a hundred years ago. Much, much faster because of technology and information and access to information and connectivity of everybody.

So it's an excellent place to be, but it's also something that can be, it's, it's a scary thing to think about stepping into. So as you look at these three areas, you know, mindset, student loans, and then, no, not knowing how things run. All of these things are things that you can work on. In particular, if you reframe a couple of these, like your student loans and your mindset and understanding that, yeah, because you're a little bit scared, that's normal.

If you weren't scared, that would mean you're like a psycho. Okay. Hi. It means you're a psycho or you're incredibly arrogant and. Or your line. I mean, there's that, that's the top three. That's about the only things I can think of because it is, is scary to think about doing that. But the fear is, is not, it's not, there's nothing incredibly dangerous associated with it.

So, you know, these are the three that I see, I want, I would love for people to be able to push past this stuff and, and start practices and, and here's the other thing. The reality is it's happening more and more. Much, much more so your item for you to think about as you might be sitting there contemplating this stuff.

Oh, you know, I want to, I'm going to start, give me two years, and I'll start. Right. I just need, I've been out of school for two years. Give me two more years, and then I'll, and I'll get going. And, well, you know what, in two years, somebody else might. Be doing the exact thing that you want to do in the precise place that you want to do it.

And you know, the more you wait, the more likely it is that somebody else is going to jump at the opportunity that you might have, but have not taken advantage of at this point. So keep that in mind as well. The longer you wait, you know, the more you put it off, the more likely it is that it may not.

The opportunity may not exist anymore. So, guys, these are the top three mindsets, student loans, and then not knowing how things work or not knowing how the sausage gets made. If you want more information on this stuff to kind of really help push yourself, pass some of these barriers, as I said before, had to F insurance, book.com.

That's a great resource. It's, it's free. All you have to do is pay for shipping and handling to get a get to you. And it's yours, it's yours, it's your book. You got it. It's about everything I've learned in the last five years of being in practice for myself. And if you want to take a deep, deep dive in a training that I did, had a physical therapy biz.com for slash masterclass you can get, sign up for that master class that we did to show you the five-step process we used to start practices in really any niche and be able to set up the groundwork for that efficiently.

So guys, thanks so much for listening to the podcast. I appreciate it. I hope this inspires some of you to take a step forward and look at it. Taking your career into your own hands if it's something you've been thinking about doing. And in particular, I love that side hustle model where you can start to, you know, get exposed to business without never necessarily having to dive headfirst, which is much scarier.

And use that as a way to help pay off student loans, down, gain experience, you know, increase your, your, your monthly. Take-home pay and pay, pay off student loans off as fast as you can, and then really put yourself in a stable financial place going forward. So you guys, again, thanks so much for listening to the PT entrepreneur podcast, and we'll catch you next time.

Do you want more cash, PT, biz help? If so, get a copy of my book. Fuck insurance. It's your playbook—so successful performance, PT practice, and never having to deal with insurance again. You can get a free copy at F insurance, book.com that's F insurance, book.com. Inside this book, you'll learn the direct techniques that we've used to become one of the fastest 100% cash PT practices in the country.