E830 | Dropoff Points When PTs Lose Momentum In The Clinic and Business With Yves Gege
Jul 10, 2025
The 3-Year & 5-Year Dilemmas: Burnout, Leadership & Long-Term Success
Ever feel like you’re stuck in your physical therapy career—or worse, trapped by the business you built? You’re not alone. In this episode of The PT Entrepreneur Podcast, Doc Danny and Yves Gege break down the two most common breaking points they see among clinicians and practice owners: the three-year clinical dilemma and the five-year business owner burnout.
If you’re on the verge of either one, this might be the clarity you’ve been waiting for.
The 3-Year Clinical Dilemma
Around the three-year mark, many PTs start questioning if they chose the right profession. You’ve gotten good at your craft. You’re no longer the “new grad.” But you look ahead at your boss’s life and think… is this really it?
The common theme? Lack of time freedom.
Clinicians get fed up with asking for PTO to go to the dentist or being micromanaged in a rigid clinic schedule. Some consider switching careers entirely. Others start dreaming about opening their own practice.
This isn’t rare. It’s actually a turning point. And if you’re feeling it, you’re not crazy—you’re normal.
The 5-Year Business Burnout
If you make the leap and start your own practice, you’ll likely run into the second major wall around year five. At this point, the excitement of year one has worn off. You’ve scaled a bit, maybe hired a PT or an admin, but suddenly the dream feels more like a grind.
You’re working more, making less, and dealing with all the things no one told you about: turnover, overhead, system gaps, poor leadership habits, and the brutal reality of inconsistent profitability.
You didn’t build a business. You built a cage.
This stage is where many practice owners get stuck—or burn out completely. But it’s also where the greatest breakthroughs happen—if you focus on the right levers.
What Gets You Unstuck
Here’s what separates those who break through from those who bail out:
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Continuity Programs: Stop discharging patients after they feel better. Learn to offer long-term, value-based care around performance, wellness, and accountability. Recurring revenue reduces the burden of constantly needing new evals—and it lightens the mental load for your team too.
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Leadership Skills: You can’t just be everyone’s buddy—or bark orders and expect loyalty. Great leaders are clear, consistent, and values-driven. Set standards, uphold them, and lead with purpose.
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Systems & Organization: Being a great clinician doesn't make you a great business owner. Without simple, documented systems, your practice will live in chaos—and you'll feel it every day.
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Financial Clarity: If you can’t tell someone your monthly revenue in 30 seconds, you’re flying blind. Your profit margin is the vital sign of your business. Track it. Improve it. Use it to build a better clinic for your team and your family.
Quick Litmus Test
If you’re unsure where you stand, ask yourself:
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Can I pull up my gross revenue from the past 4 months in under a minute?
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Do I know my profit margin?
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Are at least half of my clinicians’ schedules filled with return patients?
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Do I have core values—and hold people accountable to them?
If not, now’s the time to level up.
Final Thought
There’s no shame in feeling stuck. The 3-year and 5-year dilemmas are common—and solvable. Whether you want to become world-class as a clinician or build a thriving, scalable clinic, the key is not winging it.
Learn the business side. Embrace systems. Develop leadership. Build a culture that supports longevity—for you and your team.
Most importantly, don’t settle.
Want help navigating these phases?
Visit physicaltherapybiz.com or book a free strategy call to talk through your goals with someone who’s helped over 1,000 practices do the same.
Do you enjoy the podcast? If so, leave us a 5-star review on iTunes and tell a friend to do the same!
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: [00:00:00] What's going on? Danny Matta here with PT Biz and the PT Entrepreneur podcast. And I'm back with my business partner, Yves Gigi. Uh, and we're talking about some dilemmas today. All right, there's, there's two dilemmas that we're gonna talk about that we see in the profession in different forms. Um, and I would say we have some relevant experience with this.
We see this a lot with our own, uh, you know, our own clients, people that we're working with. And the first one is the three-year clinical dilemma. So we'll talk about what that is. And the second one is the five-year business owner dilemma. And I think this will apply to basically anybody that listens to this.
'cause you're probably gonna fall into one of these, these categories. Uh, but let's start out with this. Let's talk about the three-year clinical dilemma, because not only have we seen this, not only have we experienced this, and maybe it's not exactly three years, but it's usually somewhere around there.
Um, I. Even talking to people in, you know, the A PTA professors, uh, they're seeing something very similar with people that are [00:01:00] graduating over the last, let's call it decade, where three years into working at a clinic, um, a lot of physical therapists start to question whether they want to continue down the career path of being a physical therapist.
And they start looking for other options, whether that be outside the profession, whether that be, you know, their own business, whatever it might be. They are looking for something else and. I, I'm not sure exactly what the solution is for it. Uh, but it's something that if you are, you know, new to the profession, something to be aware of because we're seeing this happen more and more and more.
Um, and I, I think a big driver of it is the lack of time freedom. You know, I talked to somebody the other day that started her own clinic. Uh, I write about three years out and she said the, the nail in the coffin for her was that she had to take PTO to go to the dentist. And she's like, I just had, like, I have such a restrictive schedule and for her, she will eventually wanna have a family.
She's like, what am I gonna do? You know, if we have, [00:02:00] if we have kids and, uh, they get sick and it, it is a really challenging thing on schedules like that. So what are your thoughts on that three year clinical Yves?
Yves: Oh, this is a good one for me 'cause I can trace back. My dilemma. Um, and it took me just for context, 10 years of being a PT before I started a cash practice.
But if I go back, I was in the school system probably as a peds therapist for about three years. Then I moved to a little more flexible schedule as a 10 99 doing Pete still about three years. Then, you know, I ran, uh, and started and grew that insurance based clinic. That was about four-ish years, a little bit longer.
Right. And then I kind of went to, to, um, to fall into the cash. And that's something I've stuck with for a long time. So when I look back at that and from having a lot of conversations with PTs who are trying to start something or are in the [00:03:00] clinical dilemma and kind of unsure, I think three years is about that mark where it's not new anymore.
You feel relatively comfortable. You feel like you're good at your craft, and then you look around and you're like, this is what happened to me. I'm like, I look at my boss and I'm like, wait a minute, I don't wanna be that person. Hmm. That looks awful. You know? And so it's like, that's my upper trajectory.
Or maybe, I think in cases now, I'd never experience with this, but they, there is no upper trajectory probably for a lot of PTs. They're just like. I'm a PT one, and then I can be a PT two and make a little more money, but I'm basically been doing the same thing forever. So I think it's one of those two things kind of happen and that's what happened to me.
And I'm like, man, I have to find a completely different path because I don't wanna be that person for the next 10, 20 years. Like, that doesn't sound good. And, you know, that's my, that's kind of the only option.
Danny: Yeah. I, you know, I saw something similar in the military, just, um, it's just a big organization, right?
Whether you wear a [00:04:00] uniform or you wear khakis and a polo, like, it's still in an organization that's big and has a lot of infrastructure and layers to it. So, you know, when I saw what my bosses were doing and the amount of like, uh, administrative meetings they had and that they were essentially, they were treating patients, but they were managing mostly, um, like a big chunk of their time was managing.
And I even got experience doing that. I. Not intentionally, just, I had a, I had a boss at the first clinic I was assigned to that had a lot of complications with a pregnancy. So she ended up being, you know, in the hospital, um, like very early, uh, like earlier than her due date. And so I ended up coming in as this clinic director essentially, like I call a clinic chief role.
And all of a sudden I had 20 employees, basically 20 people that reported to me, uh, from multiple clinics. I had six months into graduating, essentially. This is where I got, you know, kind of just dropped in because of what happened and I. So I'm in all [00:05:00] these meetings and then I have like clinical stuff, and then you're trying to hire and replace staff, or you're dealing with, um, trying to get national guard, you know, clinicians in to cover because we had like three, um, pregnancy leaves at the same time.
Like three of our clinicians got pregnant like at the exact same time and we're all like out. And it was legitimately, I had to call the National Guard to get a, to get a, a physical therapist to come in and cover. Uh, it was crazy. Yeah. So, but this is all within a year, like within a year of me graduating, I had to deal with all this.
And that was a real eye-opener because I was like, crap, man. Like I know what that, that job looks like. And as you move up, it's very similar to like a clinic director in, in a bigger clinic, you end up, um, there's mentorship, there's management of people, there's, you know, and it is what it is. Like a lot of people that are, that want to be these pure clinicians, I don't think that they, they want to go that route so much, but if they wanna make more money, that's the route they go.
Now, this is not. You know, unique to the clinical world, like if [00:06:00] you wanna work in any sort of capacity in corporate America, the same thing can be set like they value management at a higher skillset. They then they do fulfillment. If you wanna be a consultant, you know, eventually you become a director or a manager, uh, you wanna become a partner, that means you have to drive new business because they value those skills at a different, uh, in, in a different way.
So, and this is where I think there is, um, you, you have to accept the fact that value is assigned to the work that you do. And whether you like it or not, that's just the, the way the game is played. So, uh, maybe people don't know that when they graduate, right? Maybe I didn't know that. And as you realize that like progression in your career might lead to work, you don't really want to do as much.
I think that is what gets really people very frustrated. Um, and, and then, you know, they're kind of stuck, right? They're like, okay, am I just gonna see. X number of patients per week for the next 30 years or whatever, right? Um, [00:07:00] yeah, that's exactly what, that's called a job, right? That's what people do. Like people have jobs and they do all kinds of stuff.
Um, and, and, and I'm not saying that that is what I want to do. Obviously I did not. But for a lot of people, that is exactly what they do. That's exactly what they do. Um, so I mean, there's like, to me, I look at it and I'm almost like. This is just being an adult. Like we have to just do things that we don't wanna do.
Sometimes we have to miss things sometimes. And if you don't wanna do that, then you have to create the job that you want. And that's where people make the transition, right. But for a lot of people, they just settle into that and that's their day to day and they can focus on being a great clinician and still see, you know, see a lot of patients.
But I think a lot of people find a lot of joy in that as long as they're not constantly thinking the grass is always greener somewhere else. I think that's what really makes people very sad when they look at this, almost like a jail they've created for themself, but in actuality, like it's very fulfilling job in many ways.
So I think a lot of it's the lens in which you look at that position.
Yves: Yeah. And I do think there's plenty of people, like we're a little bit, obviously in the echo [00:08:00] chamber, we're, you know, entrepreneurial, have multiple businesses and we're surrounded by people like that. Yes. So there's definitely people out there who just wanna be a good clinician.
They like clocking in, they like clocking out, like that's Yes. Uh. That's great. Like we need plenty of those people. Um, you're prob if you're probably listening to this podcast, you're probably a little bit more than that, right? A hundred percent. Yeah. So you want, like, for me it was like I wanted, uh, to be challenged regularly.
I liked different things and I wanted the ability to grow, you know, and, and if you don't have those things, it gets really, really difficult. And, and now we're just layering on just like you said, all these things that make things so much harder. Like our debt to income ratio, not there, uh, the amount of administrative and, uh, paperwork we need to do not there.
The kind of patients that we're seeing at some of these clinics, not there, you know, like the, uh, our bosses and the regulations that we're having to deal with. And like you said, the lack of PTO and flexibility when your neighbor down the street. I still remember this exact day. [00:09:00] I'm, I'm a pt, you know, I even own the insurance based clinic at this time.
I. And I go to CrossFit in the morning. I go to work, I've got kids at this time right at eight 30, and I can start a little bit later. I come home at six and I leave every day and he is there and I come home every day and he is there and I'm like, working from home. I just like, I remember that moment vividly and I was like, I want that, I want that flexibility, you know?
And same thing, like if I wanted anything to happen, I had to, you know, ask for PTO or just like go to the dentist. There's like such a lack of flexibility and that hasn't really changed I think in our, in our profession a ton. You know, you work for a hospital and you work for, you know, the, the flexibilities there, so you kind of layer all those things at top on top of each other and it's like, yeah, like of course I'm gonna be frustrated and I'm gonna, I'm gonna search something else.
Whether unfortunately it's a different profession or I think fortunately more and more PTs are like, cool, I'm gonna go do this on my own. This sounds awesome.
Danny: Can you see the [00:10:00] disrespect that my dog just, um, uh, showed behind me
Yves: off? Unbelievable.
Danny: If you're watching this, if you're watching this, my dog Sally just jumped up on my couch.
She's not allowed to be up there in the middle of a podcast, and then she knows there's nothing I can do about it. Uh, so I'm gonna, I'm gonna leave her there. And she just, she's just, just power moved me. Uh, but, uh, I agree with you, man. Um, the time flexibility thing, I think is what drives most people. In fact, I was actually on another podcast earlier this week, and you know, I think there's people that are heavily motivated by money, and there's people that are heavily motivated by time freedom.
Um, and for most clinicians, you probably didn't get into the physical therapy profession because you thought you could make a million dollars a year, you know? Um, that's not really in the cards for us. So, and, and you really. Like the personal satisfaction of being able to help people. There's a lot, there's a lot to be said for that.[00:11:00]
In fact, for me, I just couldn't, like if, if I think about could I take a consulting job with like a big, you know, consulting firm, make a ton of money work on projects with companies that I just see no personal satisfaction working with. Like, I just couldn't do that. I, I just wouldn't, I wouldn't do it. I would get burnt out so fast and I would see no, I would have no energy to do that.
So most clinicians are like that. They need, um, personal satisfaction, a mission in order for them to get motivated to, to put effort into things. So time flexibility is the big factor. And, and for a lot of people, they're not asking for anything crazy. And I think if you're an employer, you can be sensitive to this as well, to not make the same mistakes where you can create more time flexibility in the schedules of a provider because they're not asking to just work from home every day.
Which by the way, a in all it's cracked up to be, uh, you know, like just being at your home office. All day. And, you know, being on Slack and responding to emails and, you know, whatever else, [00:12:00] like being on Zoom meetings, I would much rather be in the clinic with people or, or not, not necessarily all day there either.
I think the variance of being able to have something where you can work in person and something remote is actually very beneficial for, uh, longevity in a career. And that is what people need to realize with these clinical schedules is you can engineer those kinds of things in, you need to be a little bit more creative with how you structure them, but you can build these, these, uh, weekly schedules that do not burn people out as much and create time freedom.
But for a lot of us, that's not what we experience. So we, uh, end up starting our own business. And the ironic thing is you actually have far less time freedom whenever you start a business. You know, because then you go from like, yeah, you're there, you know, your neighbor's home all day, now you're gone even longer.
You know, and you do that for years and years and you pay yourself less, right? So you, you, you end up going and starting a business. So, you know, what we see is around that three year mark. It's where a lot of clinicians that are going to start a business are going to actually pull the trigger on that because they've kind of had enough, they're, they're at this [00:13:00] crossroads, what are they gonna do?
And the paths that I see are, they either change careers, like if they're really entrepreneurial, like, you know, don't wanna be in the clinic, can't accept, accept the fact that that's sort of the career they signed up for. Um, they change careers, they go into something else and can very successfully do so, or they start their own clinic.
Right? So three year dilemma over, you've figured out what to do with that. Uh, if you're listening to this podcast, that's probably around when you made your decision. I was like four and a half years to five years out whenever this, you know, happened to me, uh, when we started our clinic. But now you start a business.
So now we get into the five-year dilemma, which is, uh, we see a lot of burnout in business owners five years into starting. So maybe you, you can hit on that if you wanna kind of talk about why you think that's such a big burnout timeframe.
Yves: Um, I think there, there's a lot of layers, um, to that, you know, and if I could summarize it in one phrase [00:14:00] and, um, I feel like the honeymoon is over, you know?
Anyway. Yeah, because it's exciting. Year one. You know, I think, uh, the upper trajectory for the first two to three years is super exciting. You have some degree of time freedom. It's a lifestyle business. At the beginning. It's very, very profitable, you know, um, you're in there and you're doing things and then you get to like year four and five, and I think either two things happen.
One is you just don't have the skillset to scale beyond yourself. Like you just don't have enough leads coming in, or you're just not good at marketing or sales. You kind of just get stuck and that gets really frustrating. Like if you've been working for five years and it's just you in the clinic and you're seeing patients all day, that just gets really frustrating.
Or you get to the point where you do try to just scale and you're like hiring an admin and you're hiring another pt and you just, you're just not very good at it. You know, ultimately you just like, you know, [00:15:00] you have a lot of turnover. You, um, get to the point where your leadership skills just get super frustrating, you know?
Um, and I think at that five year mark, if you haven't got to the point where you have scaled beyond yourself and kind of hit the sweet spot, which we, which we really like, which is 10 to 15 hours of clinical care. And the other, you know, uh, time is basically working on the business and marketing, which, which I think is.
Three to four PTs and a clinic owner like that seems to be a sweet spot. If you haven't got to that point, then you do get really frustrated 'cause you're just still grinding and you kind of look and you're like, oh my God, same thing. Is this gonna be how it's gonna be for the rest of my life? And you hit that crossroad again of like, do I, you know, this happens to everybody too.
Like if you're a business owner, I want you to, I really want you to listen to this. Everybody has moments, if not multiple moments, where you're like, did I make the right decision? Should I shut my business down? Like, we have those moments all the time. So if you're doing that, I just wanna normalize that for people, you know, like I think you [00:16:00] have those moments, and in my opinion, those are the times you kind of lean in and try a little bit harder.
But I do think that crossroad comes, uh, at that five year mark, just like you said. And, and it gets really, really tough for people.
Danny: I have a friend that is sort of a serial entrepreneur and he says, um, business I. Is the most fun game in the world when it's going well and the worst game to play when it's not going well.
Like it's, he's like, it's brutal. If it's not, if it's not going well, it's literally the worst thing ever. If it's going well, it's just like, so fun. And, and that's the, I guess that's the, the funny dichotomy of it where it's like, uh, it wouldn't be so much fun if, if you knew it was gonna work, right? Like, uh, the excitement is, you know, is part of that.
Like, it's like when you go skydiving, part of the excitement is the shoot might not open, right? Like, I don't know, you, you jump out and play and then, you know, like it likely does, but sometimes it [00:17:00] doesn't. And, and that's what makes it more thrilling, right? So you have to have the, the likelihood of failure for, for, for it to, you know, be entertaining and enjoyable and challenging, but also, um.
It's what keeps lazy people out, right? So I, I, I actually, I sent some of this stuff to, uh, to one of our head coaches and I wanted his feedback on too, what he saw with, like, around this timeline and why people are, um, you know, hanging it up if they get, you know, about this far into a business. And one of the things that, that he said, he, a couple things that I think are pretty relevant, uh, that I completely agree with.
So one of them is that you're, you've been unable to implement, so you've done a bad job of systemizing your business. So when you get started, these are two very different skills. Starting something and then growing and managing something are completely separate. They're very different. [00:18:00] And oftentimes somebody that's really good at starting something is very bad at running something.
Um, so if they don't. Build the skills of understanding how to systemize and run their business and, and to be organized, even though they might struggle with that, or to hire people around them to help with that. Um, then it's sort of flounders, uh, because it's very reactive. You are, you're um, you're, you're always sort of like, uh, responding to things versus knowing that things are gonna be like in place because of the systems that you have.
That that's a very stressful place to be. Imagine that now as an employee of that business. Very stressful place to be. In fact, it was funny this morning I had, I was rucking, so I have my, uh, apparently people in my neighborhood call it the Mother Ruckers group. Uh, uh, and that's, that's, I'm gonna own that.
I'm leaning into that. So my mother Rutgers group this morning, we had about 10 people out there, and I was chatting with a couple of 'em while we were walking, and one of 'em was telling me about a [00:19:00] conversation he had with a, uh, with a clinic. Uh, that it was, it was an employee of a clinic and he asked him, why did you leave?
Because they were interviewing this person, potentially hire them. He's like, well, why did you leave this clinic? And, uh, this, uh, person they're interviewing said, well, it was like very unstable. The owner would tell us that he thinks they're going outta business half the time. The other half the time he thinks they're growing and doesn't know he, he's like, so I didn't know if I'd have a job.
And I, I, that is not like abnormal, to be honest with you. I think that a lot of business owners are really bad at managing a business. Like it's pretty common sense to not maybe say, we might go out, business guys, like, I don't know if this is gonna work. Like you think your staff sticks around for that.
Probably not. Uh, so poor systemization being a bad leader, which that's a perfect example of, uh, and you don't know you're a bad leader until you find out the hard way. Like nobody thinks they're a bad leader and then all of a sudden, a. Your staff leaves, like people don't wanna [00:20:00] work with you. They have bad things to say about your company whenever they leave.
Um, and then you realize, oh crap, maybe I suck at this. Uh, so like, being a bad leader is a, is another one. And then also I think partially this is personality based, but some people are just like socially awkward. And that is a very shitty thing to hear. If that's you and you're hearing this and you're like, maybe I'm socially awkward.
And that is why I'm having a hard time getting to people, getting to people, uh, getting people to want to apply to work here, keeping people here, maintaining and building relationships with other business owners around me. And that can just be sort of your personality upbringing, many things, but. That is something that you can also change, improve work on, uh, to where you can, you can soften that a bit and that can really tremendously help your business.
But that is a very difficult thing to hear and to then say, you know what? I should probably change some of these things [00:21:00] because if they're affecting you that much in your business, that's probably gonna affect you significantly in your personal life as well. And that is another one that's, that is a very, very hard one.
And we see this time and time again with people in the Mastermind. I can almost pick it out, just be like, this person's gonna crush it because of X, Y, and Z. This person's gonna have a hard time and it's because they're gonna have a lot of work to do on themself and not everybody's wanting to do that.
Yves: Yeah. Um, it's. You're right, you can, somebody comes in to one of our programs and they have a lot of difficulty, uh, communicating, you know, uh, making eye contact, being emotionally intelligent. It gets more challenging for them. Yes. Um, and the hard part is, I don't know how to crack this, not honestly, but like the hard part is it's also very difficult for those people to come to realization that you don't have that skillset.
You know, it's like pretty easy to be like, all right, I suck at marketing. Cool. I might be better at this. I suck at sales. I should be better at this. Like, I suck at building systems. I should be better at this. Uh, but that one is just a really hard one to kind of, you know, uh, know. Because [00:22:00] you know, a lot of people, it's like their personality.
It's how they've been for, for a very long time. So, yeah, I think, um, that is a, definitely a huge, um. Disadvantage for those people. And the other thing I wanna highlight too, you just said it so well, was the systems piece, right? Like that is essentially that first skillset people need to develop, right?
Like, uh, you know, I think you got really lucky. Like you had, it's not your skillset. You had a wife who came in and like, that is her a
Danny: hundred percent know,
Yves: 1000% skillset, you know? Yeah. Ultimately, and I was the opposite. I was more of a systems guy, um, and not as good at marketing sales. So I had to kind of learn that thing.
So it, it was harder for me to kind of get rolling, but it was much easier for me to scale because, you know, I was able to build systems that kind of worked without me. So I, I do think that is a big, probably the number one issue. You get traction, you can get to 10 20 KA month. But getting past that, there's no way to do that.
We definitely get people who come in the Mastermind, they're like, I've been here for four or five years. I [00:23:00] average 10 15. Maybe it's 20 KA month, but I cannot scale past myself. And I'm like, do you have a lead tracker? And they're like, what's that? Like, do you have any KPIs? You can show me? What's a KPI?
Yeah. Can you pull this data for me? What do you mean? Like how many packages have you sold of the 10 busy package in the past six months? Or like, let me get back to you. Takes them a week to get back. You know? So there's so much. So I do think that is like, if you feel stuck at that five year mark and it's just you, I think the first layer is systems.
And then that second layer for sure is, which we can dig into more too, is the, the leadership piece. Um, because I do think PTs. Naturally, like you said, think they're a good leader because usually you're a decent communicator, you know what I mean? Like you can do one-on-one stuff, but it's different with employees.
You can't talk to employee the way you would talk to a patient. So like, it doesn't translate. I think as much as people think it does, it's a completely different skillset. And I was talking to a mastermind member the other day and, you know, uh, the learning curve was hard. I almost think you've gotta personally gotta [00:24:00] fail at it a couple times.
Like you gotta know what, what you don't want. You know, like the admin and the PT like hardly do it right the first time. Perfectly honest.
Danny: It's normal too, you know, and I mean, you bring up a great point, man, like, um, for a lot of people like myself that are more sort of like good at the forward facing sales marketing stuff, like getting stuff started is, um.
It's something we're typically pretty good at. Uh, but then the administrative operation side, the systemization of things, we really struggle with that. We don't see the value in it as much. We don't really know what to do with it. We don't, our brain doesn't work that way. I mean, fortunately, fortunately for me, you know, my wife is like a perfect compliment as far as like a integrator is concerned with somebody like myself that's more kind of, you know, forward facing, can go out, get business, um, and, uh, can really like, you know, like I'm not afraid to get turned down by people.
Like, I'm not afraid to go out in the community and like try to drum a business. And, uh, I just like, uh, like that's a skillset that you need as well. Because on the flip side, if you're more systems driven, you probably struggle getting started and you can systemize the shit of [00:25:00] everything, but you have no clients.
So like, that's, that is a, I think a harder place to be, honestly. Um, and you have two choices, right? You can either. You can be like myself and you can, uh, like learn the skills to be a better business owner. That's what a lot of people do, which, you know, and, and it's something that I've had to learn a lot about as well.
Um, and as soon as you're, you're like, okay, I give in, I have to learn about this. It just, you know, it's very helpful and it, it makes it your life much easier. Or you can hire somebody. Or marry somebody, I guess, and then that person works with you in your business. Uh, like that, that's not the case for everybody.
But like hiring an integrator or finding somebody that's like a more systems driven person is great, but you can't hire somebody to build your systems. I think that's like the other thing to keep in mind. You can't just be like, Hey, just come do this for me. And, you know, and that app, I see that as a huge mistake people make because then if that person leaves, you're screwed.
And not only that, you just gave away all this power of how you wanna run your business, uh, because you're too lazy to actually like, figure it out yourself. And that's something that a lot of people have to learn the [00:26:00] hard way. So the leadership side, to speak to that for a second, here's my take on that.
I think people swing wildly one direction or the other. Um, people are either just kind of, um, abrasive, uh, just kind of like difficult people. They don't realize the things that, the way they say things, their tonality, the their body language. Um, you know, it just comes across like relatively. Aggressive almost.
Uh, and, and they, they run people off because of the way they give feedback and they, maybe it's the way they email people. And so, you know, like they're very like, short and, um, direct, but not everybody prefers to be communicated to that way. Uh, in fact, most people do not like that. And on the flip side, I see people that are, they just wanna be everybody's friend.
And that is, in my opinion, just as dangerous, uh, of a place to be because it's, it's kind of like being a [00:27:00] parent, you know what I'm saying? Like, um, if you don't have kids, this may not actually make any sense to you. But if you have a dog, maybe it does my, I'm not doing a good job of that 'cause my dog just took advantage of me.
But I need, you need to set boundaries, you need to set consistent boundaries of what people, uh, sh need. What, what, what, what your standard is. And hold them to that standard and do so in a way that is really about. Helping them succeed. And when there's erratic behavior, uh, where they don't really know what to expect, that that is actually very challenging for that, for that employee because they don't know if they're doing the right thing or the wrong thing.
And you've either positively or negatively reinforced them in a way that's confusing to them. And if you're, if you just wanna be their friend, and I see this with people, you know, that I like my kids go to school with, and their parents just wanna be their fucking friend. You know, they get like, dude, grow the fuck up.
You had kids be an adult, like, hold [00:28:00] your kid accountable. 'cause your kids, your kid is turning into an asshole because you're letting them do that. Or your, your, your kid is just like, doesn't listen to adults or whatever. I see this shit and I'm just like, I know what the problem is. It's because you lack the standards that you have in place for your kid.
Now you can take the complete opposite extreme, like, like families that I grew up in where it's very regimented, very structured. My parents were not my friend. Uh, not even close. And in a lot of ways that's a generational thing, but because of that, they raise people that are independent. And if, if, if you're taking this from this parenting example to your own clinic, you have to have this, this gray area that you function in between friendly.
And uh, also like lead them with standards that you uphold yourself and you can't swing wildly one way or the other because that's what drives people away. And that can be a very hard thing to do because [00:29:00] you may not have much experience with that. You may, you're like, oh, well you know what? Let's go grab a beer.
We can talk about this. Like, sure, whatever. And then that person starts to take advantage of you and then you swing back the other direction wildly and all of a sudden now they're confused because you just are like friendly with them more so than you probably should be. And it's sad because a lot of times you hire people that you would love to be friends with.
Uh, but you can't, and that sucks, but that's what you signed up for. So you need to have a peer and then leave and let them hang out with their coworkers, because that's how you build culture. They build, they're, they're with their friends. You're not one of their friends. You're their boss. You're, you're in charge of it, and you can be friendly and, and want the best for them, but you can't get emotionally so deeply tied to them as, as a, as a friend, because what if you have to let them go because it's the best thing to do for the business.
You're in big trouble. If that's the case.
Yves: Yeah, you said it, uh, hit the nail on the head. Like there are people that are very confrontational and people who wanna avoid confrontation at all costs.
Danny: Yeah.
Yves: It is that dichotomy that [00:30:00] you need to live in. You know, I swung hard the other way where I don't like confrontation.
I don't necessarily wanna have uncomfortable conversations, you know, and you can use the excuse I did of like, they're adults. They should manage themselves, you know, raw, right? Like, you need to be able to just, like you said, uh, set the standard and then also enforce it and be consistent. You know? I think that is, uh, that's also a big challenge, right?
Because I. At this point, you know, in my career trajectory, I'm having uncomfortable conversations all the time. You know, like, it's just like I have more uncomfortable conversations than, um, I've ever had to have, you know, with employees, uh, with business partners, you know what I mean? Like all that, it's, it's just challenging.
But, um, I have noticed the more uncomfortable conversations I'm willing to have, typically the bitter, the better the business does and better the employee does too, right? So like, if I wait to tell somebody who's being, uh, a jerk to one of the employees and I just wait months to do that, you know, [00:31:00] it'll fester and it'll get worse, as opposed to like just telling them immediately, and I don't want to be a jerk about it.
I can do it in a kind way and just be like, Hey, this is what's going on. You know, you can't talk to people this way. This is what this looks like. You know, I know that you're better than this. Like, just having a quick conversation like that, although really uncomfortable in the moment. Almost afterwards, you know, just I think like your kids, right?
Like they'll respect you more, you know, they're, um, they'll appreciate the standard and culture that you've set. Um, you just gotta get through that. Uh, at least for me, that initial con conversation and that uncomfortableness. And then on swing on the other side, which, which I see plenty of mastermind members do, is just like, you know, not softening up a little bit.
Like you don't have to go in there and come guns, guns a blazing. Like I think most PTs are typically very kindhearted, need to be nurtured. Like look at the kind of profession you're in, and if you're super abrasive, I just have not seen that work. Maybe, maybe in other cultures, like in other professions, but in ours, for sure not, right?
Like, there's definitely more of [00:32:00] a, um, I'm not gonna say handholding, but a little bit more of a soft touch when it comes to, to, to leadership for most of the, um, PTs out there.
Danny: And that's fine. I mean, because the, the. The personality fit of the people you're working with is, it's a better approach to do so.
But where I think people can really improve here is to have their core values established to, for your team to know what your values are and to hold people to standards based on the values. So, you know, if you have a core value of, you know, uh, punctuality, you know, people's, uh, valuing people's time, and you have a staff member that continually shows up late for things, this is a perfect opportunity where you have to have a conversation with them and say, look, this is one of our values.
Uh, this is why it's one of our values. And right now you're not upholding that, like you're, you're, uh, [00:33:00] you're wasting the time of these other people. That's not something that we're about. And now we, we've addressed this. You know, like, I want you to know that this is something that we, we find very important and we expect people that are part of this team to do so.
Because when you show up late, you, you show everyone that you value your time more than them, or you don't value their time the way that you should. And in our company, that's very important. And now they know. And if they continue to do it, uh, that becomes something that is, uh, it has been addressed and now it's a continual habit.
And that might be somebody that doesn't actually match your core values for your company that you might have to, you know, let go or they leave. Uh, because as you hold people accountable to what your standards are, they either fall in line with the standards, which are not like extreme. You know, like asking somebody to, to show up on time is not extreme.
It's just like common courtesy. But if somebody does that, this is just a common example, we see this a lot, right? It's just like, you gotta address this, but they need to know why. Because if you're just like. [00:34:00] Dude, just show up on time. Okay. That's not, that's not enough. Like it needs to tie to, like, this is, this is what we say is for our core values, this is why it's important, and this is why it's important to the people that we work with.
You know, like they're taking their time outta their day. Don't waste their time. Uh, be punctual, you know, and that might be okay. We need to better organize your schedule. Here's how we gotta make sure that you're, you know, able to do administrative side of things you have to do for your patients. There's things that maybe we need to help you buffer and learn around there.
That's fine. We can, we can do that. Just wanna make sure you understand why it's important to us, you know, and be on the same page with people, and then positively enforce that, right? Like, this is something where when you see somebody, uh, making improvements, you can bring this up in a, in a meeting, you know, and be like, yo, Brian is killing it.
Brian, I just wanna let you know, you did a great job this week on time with all your, your, your patients. So glad to see that, you know, you're taking their, uh, this core value seriously. You know, thanks for all the hard work and like bring that up in public. And address that. Like that is a really important thing to do, is validate people.
But the mistake that, that I see a lot of people make is they just avoid those conversations completely because it is [00:35:00] uncomfortable and, uh, it's uncomfortable for everybody, okay? But it gets more uncomfortable if you wait longer. And the more that you wait, the more it just turns into, um, a bigger problem.
And then you have more anxiety about it. Like, imagine, like, let's say, you know, I don't know, you're doing something that kind of gave you some anxiety, something that was maybe let's just talk about just jumping outta a plane. Okay. Like, we'll go back to the jumping outta the plane example. Uh, let's say, let's say, you know, your friend is like, Hey, I wanna go skydiving.
You want to go later today? You know, and you're like, yeah, okay, sure. Right? Like, you only have half a day to stress about that. But if your friend's like, Hey, uh, in two months you wanna go skydiving, you know, they're like, okay, you have two months to think about that shit. Like, that's a long time. For something that might freak you out.
Right. Uh, and so just, just rip the bandaid off, like do it in a respectful way. The, the one thing I want to, uh, transition to with this too, from leadership obviously, is a huge problem where people run into not being able to maintain staff, not be able to, not, not be able to, like recruit [00:36:00] people as well because of that.
But one of the big problems I see, which is that I, I guess, runs hand in hand with this, is a lack of profitability. And when, when you go through a growth stage and you thought, you brought this up earlier, so it was early stage profitability, it's just you, you know, you might be making $20,000 a month gross revenue.
You know, you might be at 70, 75% net margins, but you're doing a lot of work. You're the only one doing work. Uh, but you're, you're able to actually net a decent amount of money. Compared to working for somebody else, you make the decision to grow past yourself, to create non-active revenue, to create a business that that actually has value.
To try, lemme lemme say it this way, to try to do that because it's not a guarantee, it's a hard thing to do. You then take a step back on the net profitability 'cause you're reinvesting in a space, you're reinvesting in people's salary, you're investing in improved tech stack. All these things that are gonna be able to improve the business overall.
And at the same time, [00:37:00] you're lowering what you're making. So you're working harder, you're taking on more risk, and you're making less money. And for a lot of people, if they can't break through that stage and get to the point where they're at, at least, you know, $50,000 a month in revenue, if not more. With good profit margins, uh, they start to question whether it's the right move or not.
And. They're also doing everything and they can't actually hire administrative folks that are operationally savvy and smart. They can help offset some of the work they need to do. So I think the financial constraints that people see, in my opinion at least, is what really drives people to wanna, like, they wanna quit, right?
They're just like, oh, this sucks. Like I'm working on, I'm working so hard. And they never hit the profitability numbers that they wanted to, and then they kind of failed at like actually growing a team. You know? And that's a shitty thing to, to feel
Yves: you're spot on. I think that's when it gets really, really hard to get right.
Like the beginning stages I think [00:38:00] are the hardest, right? Just to get the traction, do all the marketing sales, you don't know what you're doing. That's really hard. And it's probably just as hard right at that spot because if you do it correctly, just like you said, you have an admin, you have a tech stack, you have one, maybe two PTs, and you have a standalone space and you.
As the owner either need to drop your clinical schedule down, which is less revenue.
Danny: Yep.
Yves: Or you need to create more time and sacrifice probably your health or your relationships for a little while. So like, that's a lot. And if you, it's so spot because if you get stuck there, you can't sustain. Like you will, like we, that's when, that's probably the only other time we see businesses, you know, uh, not fail.
Yeah. I mean, we, not a lot, but a few, right. Like, they just get so burnt out. They just can't sustain that long term. And, and it's, it's so difficult because Yeah. And you're making no money, at least in the beginning, you're bringing home, um, some money. You're not managing people too. So it is truly, uh, [00:39:00] again, the hardest spot and it's just.
Just to echo it, again, echo that key of systems and leadership, like that. Skillset is the only thing that will get you to break through. And it feels really frustrating that stage if you can't, because losing a staff member is really, really hard. Sometimes. Not, sometimes those things are out of your control too.
Having a bad landlord, there's also like a lot of things that aren't in your control as much as before. Again, you know, and it's just tough. Yeah. They just can't stay there forever. You have to, um, be able to, to push through that on the other side is the best, right? Like we see so many people flourish when they get to that four PT standalone space or in it and they love it, right?
There's ups and downs as always, but like that's the, I think the ideal spot to be in is a cap shown. Um, yeah, no, that's a, you're right man. That's a really, really tough stage for lots of reasons.
Danny: Well, I think for a lot of people, the what they really need to shoot for, if they're gonna do that, and it's changed, uh, somewhat, right?
Because of, um, the, the cost of things in particular, but. [00:40:00] For a lot of people that are gonna grow past themself, it should not be, Hey, I just need to get to like one other provider and I'm good. Two other providers. I don't think that's enough. I think you need to really try to get to the point where you're generating, um, you know, a hundred thousand dollars a month in your clinic.
So when you, when you look at, when you look at the dynamics of this, so number one, there's safety in numbers in a lot of ways. If you just have one provider and they leave and, and maybe they leave because they don't like working at your clinic, maybe they leave because their spouse gets a job and somewhere else and they have to move.
These things happen, right? Like, uh, there's going to be transitionary, you know, workforce changes that are gonna happen no matter if you're the greatest company to work for, ever. It's just naturally gonna happen. And it's very frustrating for people, but they just have to accept the fact that that's the case with any business, not just a service-based business like this.
So when, when you accept that and you just say, okay, here's the target. If I need to be at a hundred thousand dollars a [00:41:00] month in revenue and I need to back into, let's say I have clinicians that are generating $20,000 a month in gross revenue, just as a simple example, that means I need to have five clinicians, you know, working there.
If I'm not, um, you know, if I'm not the one that's, that's seeing a bunch of patients, which you probably can't see too much at that point, so let's say you need to grow to five. They need to all be, you know, relatively busy. You need to have a good average visit rate. Um, and then you need to do a good job of managing your overhead and not getting too bloated in terms of your fixed costs.
If you can do that. You should be able to be somewhere in the net profit range of probably like 25%. Um, you know, just, just, uh, as an example of what we see with providers that's net profit, it's probably gonna be close to like 30, maybe even a little higher in terms of owner's discretionary income.
Meaning you, you with net profit, you would remove your salary, uh, from that, like what you're paying yourself. Um, but you would add that back 'cause that's what you're taking home essentially, right? So when you're there and you're doing like a hundred thousand dollars a [00:42:00] month, then you're talking about somewhere between 25 and maybe $35,000 a month in income.
Uh, depending on how much you're reinvest back in the business. It could go down from there. But that also, what that does is it gives you. More resources to reinvest back in your team, in your culture, in your, in your, your brand, um, in the, the compensation structure for your staff, the benefits, all these things that make it a more enjoyable place to work in.
You need money for that. And my wife, you know, she used to run nonprofits, uh, and like a military nonprofit called Operation Home Front. She started the Hawaii chapter and worked at the Texas chapter. Um, and they had a saying in Operation Home Front, and there was no money, no mission. And it was because like a ridiculous amount of what they, what got donated went to the mission.
It was like 98, 90 7%, you know, it's like, and, and because of that, it was like terrible salaries for everyone that worked there. Just, I mean, it was basically like a slightly paid volunteer, [00:43:00] uh, in this, in this nonprofit, but did great work. But no money, no mission. And when you are in your business, you. You need to think of it the same way.
Like you need money in order to create a company that provides fantastic, uh, fantastic work environment for your team and, and you all can work together and, and end up in a really cool place if you are able to actually grow a profitable business, period. Right? So like that, that is the key I think for a lot of these folks is, and this leads to leadership, this leads to systems, it all comes back together.
It's all the same thing. And it comes down to you becoming a better business owner, like period. You know, and this is what I see as a huge mistake, is people that are just clinically, they're good and they grow their clinical schedule themself to where they're full 'cause they're a good clinician and they're good with people, whatever, and try to scale past themself and.
They get punched in the face with the reality that they don't have any systems. They're a bad leader and they don't understand [00:44:00] the first thing about their business finances. And to make that mistake and realize it kind of sucks. Uh, but you know, if you can just understand that you didn't go to business school, don't take this the wrong way, I thought I'd be fine.
I was not. Like I had to actually get punched in the phase two to realize that I sucked at business. And, and then it's like, okay, cool. This is what I need to fix. And you lean into that the same way you leaned into trying to become a great clinician and apply your skill of learning and being diligent and, and, uh, work hard and you gain that skill.
And that's where you see the growth in the, in the business. But normally, I think for a lot of people that shift of understanding, I don't like I'm built this thing, but I don't know how to actually like run it. It's like, it's like you built a, a, a manual car, but you don't know how to drive stick. And so you maybe you get it moving, but it's not gonna be very functional.
Yves: Yeah, I think a lot of people, 'cause we're not naturally business owners, right? Like I don't think many of us are. Um, maybe there are a few people who came into this and like wanted to own a clinic and [00:45:00] they're super interested in it. Yeah. But most of us did. And um, what I almost wanna emphasize to some of these people, maybe it's a five-year mark or whatever.
Or any stage of business really is like the number one health metric, um, is gonna be profitability. Yes. No matter what. So like, don't feel bad about profit. Like I feel like there is some sort of stigma, like we have some money mindset issues in our profession, but like, you should be very exceptionally profitable and don't feel bad about that.
Like it's actually don't look at, look at it. I'm trying to get somebody to change the way they're thinking about it. Don't look at it as profitability, is money going to my pocket? Look at profitability as like the measure of the health of the business, right? Like we measure the health of ourselves through blood work or measure the health of how we're doing with our patients through outcomes and things like that.
Like that is the measure of your business. And if it's five or 10%, like that's not good. You know what I mean? Like, we wanna be at 20% or higher, and if we're not, we've gotta do those things. Like that's the, the number one, like ultimately the number one macro [00:46:00] metric is if your business is doing well or not.
Like I can tell you within a few minutes and there's different profitability, different stages and there's nuances. But ultimately you wanna be exceptionally profitable and that, you know, will allow you to pay your people more, grow if you want to. You know, just gives you way more options. And I think that's so better.
And if we wanna, wanna a little bit, if we wanna go back. One degree or one tier back. Um, and we look at the five-year mark and how do I break through? Where are those KPIs? I think you kind of said it is price per visit, like, is my average price per visit $200 or higher? And the other one, which I think is ultimately a good sign of leadership and people don't look at is just utilization rate.
Like, yeah, are people seeing 85% or more on a consistent basis? And if not, then something is going on. Like, that's like the key leadership metric I look at. I almost, I asked that first before anything else. I'm like, how many available visits to your PTs have? Where have they been? Like, and it's usually I hear it's like, well, they can see up to 32, but they're stuck at 15 to [00:47:00] 20.
I'm like, well, let's, let's, that's the problem. Let's fi you know, now we can reverse engineer that. Um, which I won't go down that rabbit hole, but like, you know, there's multiple things that we need to look at kind of beyond that metric. So I like those two metrics. If you're kind of stuck,
Danny: you're right too.
I mean, the. Utilization ratio is really important. Uh, to me, I think what I, what I wanna dig into even more with that is what percent of those visits are coming back to see your providers that are not new. So we would look at that as like, what percent is recurring, because one of the things that, um, is just so important in a business is the non, you know, new revenue, the recurring revenue or reoccurring revenue.
So, and there's a couple reasons for that. One being it's more stable for the business owner. You can forecast and project better, um, versus sort of this eat what you kill model, which is just based off of new business only and there's no sort of snowball effect on the backend. But the other thing too, you gotta keep in mind from a longevity standpoint for a provider [00:48:00] and, and you just gotta put yourself in their shoes.
When you see somebody that is a recurring patient, um, so mentally so much easier. Like, and in a lot of ways it's just, it kind of gives you a break from solving complex medical problems that are like more intense evals. And if you're just doing intense evals all the time, and this is basically what I did in the Army, we're just eval and re eval machines.
We don't get to work with people through a plan of care. We don't get to see people on a continuity basis. Like, you know, we see somebody once every, I don't know, anywhere between two and four weeks, maybe two and two and six weeks, depending on the location that I've been in. So, you know, you're basically building out this long plan of care and then a PTA is taking 'em through that and you're just doing the like, you know, heavy lifts of the evals and the als.
Um, so, and that, that's strenuous mentally. Uh, so if you can get somebody's schedule to where half their schedule is people that are cool that they like working with, that they, you know, enjoy, uh, helping [00:49:00] solve like. I guess progressive health and wellness goals that are non-reactive, right? Like you're not solving a problem, you're trying to work towards a goal and, and maybe not have a problem or work towards performance.
That really decreases the mental lift for a provider because, you know, I'm not seeing patients anymore, but it's not like, I forgot what that feels like to see, you know, seven one-on-one visits a day. And if half of those are evals or like new patient case studies or like new patients that are, you're like heavily trying to solve a problem with versus man, if that's like a recurring person that is just, it's just like a mental break.
And I think that actually lends itself to, uh, much longer times of, uh, periods of time where you keep staff around.
Yves: Yeah. Well said. I, I, uh, just thought of a great, uh, reel. Um, but like, why is continuity and lifetime value so important? And basically it's less stress on the owner and less stress on the clinician ultimately.
Danny: [00:50:00] Yeah.
Yves: You know, what's like one of the number one things that we work on, because getting new patients is very difficult, takes a lot. It's nuance. There's multiple things. And typically it's much easier for a provider to really focus on a continuity program and keep people around long term, which will just significantly decrease the number of new patients.
And then as well, just like you said, just like happier clinicians because you know, you also get to develop relationships with those people like both me and you, you know, as we started to grow and scale our. Caseload was just continuity people, people we saw on a monthly basis or um, you know, pretty much regularly.
And like those were awesome visits. 'cause you have a lot of rapport with those people. Yeah. You're not doing, typically, you're not doing as much critical thinking. You really enjoy it. You kind of, you know, and now I've got a lot more bandwidth for these other things. So yeah, I think that's, um, um, I think that's huge.
You know, and, um, if you don't have a continuity program, you should definitely start working towards one. You know, we'll go down that rabbit hole of like why that's important and, you know, [00:51:00] let's just discharge people left and right. That's a whole nother maybe podcast, but, um, yeah, I think that is, uh, it's a superpower for our business if you do it well.
Danny: Yeah. And, you know, we'll wrap it up, uh, here, but I will say when you look at continuity or we consider like, recurring visits, people coming back in without necessarily, you know, just having to focus on new patients. Uh, if there's anything that I could go back and tell myself like day one, you know, uh, of what to.
What's it like, don't overlook, you know, like, like make like, hey idiot, make sure you focus on this, right? Like, that's exactly what I was walking into my little windowless room office and just be like, Hey dummy, you stop discharging people. Like, this isn't the army, right? Like, like you can see them more than three times and they like working with you, so give 'em a reason to stick around.
And it took me a good solid year before I realized that. And even then, I didn't even really put any effort into it. They just, people just would come back on their own. And, uh, [00:52:00] if I had done that, you know, like, like the math on it, in the first two years we saw something like. 600 new patients, uh, like a ton.
I was getting tons of evals. This is just me. So let's call 600 and let's say I just could take a third of those people and, and have them stick around even once a month, right? Uh, on a, on an ongoing basis. That means I have 200 visits that I have that are coming in, in a year, uh, ongoing. Right? Just, just popping in.
Uh, that's an insane amount of money, uh, every year, right? So like 200 people times, uh, $200 a month. Like they're coming to see me once a month. That's $40,000 a month. That's half a million dollars a year. That's, that's two people's schedules. I left on the table because I didn't have any idea about what a continuity offer [00:53:00] was, why recurring revenue was important and honestly didn't have the money mindset to even have a conversation about somebody, uh, somebody coming back and seeing me because I didn't know if there was value there.
So that, that is a massive mistake. And I'm telling you, I say this all the time, I can't, I can't make this more like important to like, listen the fuck up to what I'm saying, that those numbers are like, they keep me awake at night thinking about like what I should have done and why it's so important for other clinicians to do this.
And yet they still don't listen sometimes 'cause they don't think they fully understand until you're in it and you're like, oh shit, that's what he's talking about.
Yves: Yeah, I think, um, I would tell myself the same thing but in a different way. The thing that I didn't understand, and I would say this exact thing, is like, just because somebody isn't in pain doesn't mean you can't keep helping them.
Danny: Exactly.
Yves: That was a huge thing for me to overcome. 'cause I was like, cool, within normal, normal limits, okay, you're functional, see you later. Like even in a quote, cross the gym performance based practice. Like, it took me a long time to get to the point like, oh, okay. Like, uh, I [00:54:00] don't know if I didn't think people wanted it.
I didn't know if, I just didn't think I had the skillset. I don't know what it was. Probably a combination of all those things, but as soon as I got kind of over that man, like things opened up. So yeah, I would just scream that in my ear. It's like, just because they're not in pain doesn't mean I can't help them.
Like,
Danny: yeah, please. It's a great point. But like you come from the insurance world. I came outta the military, like if somebody didn't have pain. Get outta here, dude. Like, I have a six week wait list for somebody to get an eval with me. You know, like I just don't have the bandwidth for this. And it doesn't mean that it's not the right way to work with people.
And it doesn't mean this. That's not how people want to be addressed. And I mean, if you really look at like, the push towards lifestyle medicine, so many people are looking for things like this and, you know, it's, it's a great place to, to fit that in. And it's a fantastic way to continue to learn about, you know, how to work with the human body, right?
And, and the human in general, because there's a lot of other factors there, uh, that you need to learn how to, you know, uh, coach and, and hold them accountable. And how to ask questions about what they [00:55:00] want to actually achieve and help help. Game plan, how they're gonna do that. Like, there's so much we can do with people that leads to not getting hurt, not having issues.
Um, I even myself, like I used to wait until I was like jacked up before I would go, go to, to the clinic that I sold, right? And it, and as, as part of the sale agreement, I can go there whenever I want for free, right? And I literally wait until something's wrong with me. Uh, like a, like a fool. Just, and it's what most people think, right?
And I know better. It's just, you know, time, time busy, you know, or, or time poor and, and there's other things going on and you don't really think about it. But like, to have somebody that you can go to on a regular basis to keep you healthy is such a valuable thing for so many people. Um, and, uh, and, and I think as a profession, that's not what we learn in school.
That's, that's absolutely not what we learn in school. It's not what you learn in a clinic that has insurance. Uh, you know, that's, that's, uh, the primary driver of the revenue. It's just they're not gonna get reimbursed for it, right? So it doesn't mean that's not a valuable skill. And that's a really well, well said, uh, example.
So, alright, let's, let's summarize this. So look, three years in clinically. [00:56:00] You're getting burnt out because you look at what your bosses are doing and you're not sure if that's what you wanna do, if that's what you're feeling, that's normal. Um, you know, if, if, if you do want to stay in a clinical environment, my advice is double down on being the best clinician you possibly can.
And I think, you know, there's, I don't know if the right best term is nobility in this, but like, there's nobility in being world class at something and you don't have to start your own business to do that. And in fact, I think too many people don't look at what they do as something that they should be trying to be the best in the world at.
And that's, in my opinion, a big flaw in, um, just I guess society with social media, you know, we see so and so is jet setting off to another country and, you know, whatever. And people, people make themselves feel bad because they see other people doing things, but. If you're sitting in an office [00:57:00] and you're helping people legitimately get out of debilitating injuries and back to what they do, that is fantastic.
That is like in incredible thing you're adding to the world. You should feel proud of that, and you should try to be as good as you possibly can be at that. So if you, if you're not thinking about starting your own clinic and you feel like you're getting a little burnt out in the profession, double down on being fantastic at what you do for a living and understand that you're adding a lot of value to other people's lives.
If you're sitting there and you're just like, I need more, I need more of a challenge, I want more time, flexibility, the, the, the business side of things is a great direction for a lot of people to go. Or maybe you change careers. Um, but once you get started in business. Again, you're gonna hit this plateau.
You're gonna hit this sort of, I don't know, invisible wall where it's like, oh, five years in roughly for a lot of people and you're just eating shit every day for five years. Like it's hard. Um, and in order to get your business to a place where it doesn't feel like you've created a cage for yourself, you have to have [00:58:00] systems.
You have to be a good leader, and you have to have a profitable business. Step one, understand your finances. Step two, make sure that they're in good working order. Otherwise, you're never gonna get out of the day to day of doing everything in the business. And you're never gonna even make enough money to hire smart people or give your staff enough compensation to keep them around long term to solve your staff churn problems, which are gonna lead to you even getting more burnt out.
You know? So it's, it all sort of feeds into itself. Um, but those are the, the big areas that you need to focus on and address. Um, and if you don't know how to do those things. That's okay. That's why we exist. That's why companies like PT Biz are around because we didn't go to business school. You know, we went to physical therapy school.
Uh, but it doesn't mean that you can't learn how to, you need to learn how to be a good business owner in order to have a successful business.
Yves: Yeah. Um, one thing that we didn't hit on as much, and even within our programs that we just harp on knowing your finances personally and business wise. Yeah. [00:59:00] And we still have so much trouble getting people to look at this, and I feel like that is just another key skill that, um, it has to happen.
Like, just understand where you're at, you know, understand where you are right now, right? Just like you are with a patient. I need to understand, that's why I do an evaluation. I understand where they are and know if they're making progress. And so, you know, do that for you and your business. Don't keep your head in the sand.
Don't be like, it's just gonna get better. I don't wanna look at this. I don't have the time. I think that's just another key skill that a lot of people, um, don't have, you know, and, and a lot of times probably causes them to like not get help, you know?
Danny: And we'll, uh, like, we'll end it on this. Here's a easy litmus test for you.
If I asked you to send me your, uh, p and l, your profit and loss sheet right now, you know what? Let's make it even more simple. Send me your gross revenue for the first, uh, four months of the year. And if you can't do that in about 30 seconds, you do not have a very well tracked business as far as your finances go.
I'm not even talking about all the [01:00:00] expenses that are coming outta it. I just wanna know what you made. And I can tell you half the people in our fucking mastermind couldn't do this right now, because if we ask for financials, it's like. Pulling teeth to get them to send these suckers in because the discomfort of the fact that they're not tracking the right things.
So if you're listening to this and you're our mastermind, I'm talking to you, get your shit together because that is a very, very simple step, and it's gonna take a lot of stress away from your life if you have your finances together. Right? And these are people that we work with. I can't even imagine people that we don't constantly, you know, badger about getting their finances together.
You know, you just avoid it and you avoid it, and you avoid it. It's, or, or it's like your personal finances. If you don't know what you spend on a monthly basis and you can't, I could tell you in two seconds, I track this stuff every single month. I can tell you the percentage of, uh, money that we spend based on the percentage, uh, compared to the amount of money we make, the ratio.
I can tell you this for the last three years, because I track it every single month. And I sit down and I look at it on a, literally a monthly basis, and I do a little meeting with myself, a little financial meeting, [01:01:00] and I knock it all out because it makes me feel so much less stressed out. To know where I'm at on the personal side and on the business side.
And if you're not doing those things, you're a hundred percent right dude. This is a habit anybody can learn. You just have to get over the discomfort of the start starting. It sucks 'cause getting everything organized and you're like, oh my God, that makes me feel bad. But you can't stick your head in the sand with those things.
You've gotta know where your business is at. You gotta know where you're at personally. Otherwise, how do you know if you're even tracking the right direction, if you're making progress, right? I mean, it's just, it sounds logical, but for a lot of people, they have such a hard time with that. That's it.
That's it. Alright. Litmus test. Send me your revenue. That's it. Alright, dude. Thanks for, uh, for, uh, for chatting and hopefully y'all got, uh, something out of this. If you're, whether you're at the clinical stage where, you know, you're hitting that sort of three year dilemma, not sure what to do, um, or you start a business and you're closing in on, you know, five years in and you feel trapped.
Uh, these are the things that we see that really help you make the right decisions to kind of break out of those ruts. [01:02:00] Uh, and hopefully, you know, this, this helps you, um, you know, with the next step of whatever you decide to do. So as always, thanks so much for listening and watching and we'll catch you the next one.