E192 | Growing A Successful Pelvic Health Cash-Based Practice With Nicole And Jesse Cozean

 On episode 192, I interview Nicole and Jesse Cozean of PelvicSanity in Laguna Hills, CA.  They run a cash based practice that specializes in all aspects of pelvic health.  We discuss how they got their start and where they stand as a business today.

Up for a Challenge? Try our 5-Day Challenge Here! https://www.physicaltherapybiz.com/challenge 

Episode Transcription:

Danny: [00:02:30] What's up, guys that get here, the PT entrepreneur podcast, and today, I'm fortunate enough to have two, two people that I think may have one of the faster-growing cash-based practices that I've learned about in the, you know, in, in the few years that I've been doing this podcast, I felt like I had to them on.

Nicole and Jesse Cozean, they own Pelvic Sanity out in Laguna Hills, California. And, as of, as of now, they have a, there's, there are four providers there. They've been in this for, and I think three years.

Nicole: [00:03:14] Yes, we just had our third anniversary,

Danny: [00:03:17], which is incredible growth. I think it's, you know, something that's, you know, it's just cool for other providers to hear this.

I think a lot of people listen to this or they're like. They're lurking, they're thinking about starting a practice there. Maybe they're in the side hustle kind of, you know, a portion of their business where they're still, you know, working another job and they haven't decided to sort of leap yet.

And so I think this should be motivating for them to kind of hear a story of somebody that in a short period is, you know, built an impressive business. So, first of all, I just want to allow you guys to jump on and tell us a little bit about your, your practice as it kind of stands right now.

Nicole: [00:03:50] Yeah. Great. Okay, well, thanks for having us on, and we're excited to be here. So we have, like you said, cash-based practice in Orange County, California. Right now. We just hired our fourth physical therapists, and including me, makes five. So we have five PTs. We have a massage therapist. We hired a front desk person, and I don't know, like six months back or so.

And before that, Jesse was doing all of it. And which is interesting, I think we learned a ton from that. We can get into that in a second, but yes. So that's kind of how we stand right now. We've already had to expand our staff space, which was a little bit interesting because we couldn't expand physically in the current area that we have.

So we rented a space in the same building and have a little gym back there, for our exercise stuff and our mindfulness classes. And so we've been able to kind of grow and offer a lot of fresh opportunities for our patients to get back to better pelvic health.

Danny: [00:04:49] Yeah. I think that's amazing. I mean, everything you just mentioned, right?

So like massage, mindfulness, exercise, physical therapy is this sort of like kind of holistic approach, a comprehensive center that you're developing, which I think is just so, it's so beneficial. And it also, it goes so well with the handoff to the right people to, you know, and, and sometimes that's the hardest part.

It's like. Okay. Yeah, we're kind of done with this side of it, but I keep sending people to trainers that are sort of inadequate, and they're kind of screwing up, but we work so hard on, and then it's like, all right, well now I've got to build that and then bring it on. So it seems like you guys have done that an excellent job of that.

I'd love to kind of hear about how this started. So why did you start it, and how did that the end. Yes.

Nicole: [00:05:27] So it's interesting. So Jesse always was pushing me to kind of do my own thing, and I was, it's still like, I'm not a business person. I don't want to do that. Like I knew myself enough to know like, hell no, I am not going to sit there and crunch numbers and be all nerdy with that.

Like, that doesn't do it for me. Right. Like I'm a physical therapist, I want to treat patients. So, but she is a little bit more. That, as entrepreneurial business stat comes from a family of that, does that. And so I think that he never really even thought twice about not doing that. Yeah. So I started at a hospital-based setting, so I've seen how that works.

We tried to grow.  And then I went to work for a smaller place, basically like this one, from a person who had also broken off from a hospital-based clinic. And that was a cool symbiotic relationship as well. And I was the clinical director there for about five years.

And then we decided to break off and do our own thing. However, it never really was. It was going to be a real place. This Pelvic Sanity started as a blog that didn't do very well, honestly. Yeah. And we never really like, you know, it was always like, yeah, I've got to start writing my thoughts down from a pelvic health standpoint.

And like Jesse was like, well, let's start a blog and we had an idea to write a book, and so that was sort of all in the works. And then, through a series of events at the current, at the place where I was working, I was just like, you know what? I wasn't 100% happy. And I was like, let's just, let's do it.

And we had basically like this big family planning session where we were like, okay, are we going to have kids? Yes or no? We decided yes, but we also agreed that we wanted to be happy with our lives when we started to. Do that. And so we kind of just sat down kind of with my parents and stuff, and we're like, you're moving down to Orange County.

Like we're going to start this practice and see where it goes. Cause if we don't do it now, we're not going to be able to do it as well as we want to probably for the next ten years, and my parents were like, laughing at us. They were like, if you don't do it now, you're never going to do it. So, yeah.

So we kind of like had this big like life planning kind of session. And then we were like, okay, go. And that was in like November, December, and then we opened in, in technically April, but we have this location starting in May.

Danny: [00:07:54] Wow. So

Nicole: [00:07:55] it was really, it was fast. For that part, but not necessarily in like the, we preplanned for a long time.

Danny: [00:08:05] What seems like you guys are so intentional? I would say, I mean, I've never sat down my wife, or we did not do this before we start a practice and thought to herself, what kind of life do we want? You know, like where do we want to be whenever we have kids? We just. We just had a kid, you know, and then we had another, and I think that's amazing.

Now you guys are, maybe it's like a California cool thing. Like my friends that live in California, Southern California particular, they're just more relaxed than me. They seem to have their shit together better than I do. And, I, I, I don't know if maybe you guys are just exposed to more of that sort of like.

Intentional kind of living and, and, and, you know, the self-perspective of, of, of where you want to be. And I think it's great. I made sure to hear Jessie. It's intriguing like she grew up in a family of entrepreneurs. So for you, like, like the risk side of it is just average. Do you find it like, I know for most of us, what we get into it, it's like, dude, this is crazy?

I can't believe I don't have a paycheck. But for you, I mean, that's just kind of the way your family was, huh? Yeah. That is.

Jesse: [00:08:59] And then I had been consulting, which is kind of what led me to, they come and be able to be at the clinic cause I had been working from home and consulting with small companies.

So this was right in my wheelhouse. So yeah, so if you're not scared, you're not doing something right. Right. That's the, and I had just seen. For so long, Nicole, frustrated in not being able to provide the kind of care that she wanted first in, cause we first started dating, she was, you know, running the program at home hospital and, you know, stuck in that insurance mindset and all of that and how frustrating that was from the patient.

And then even moving over to private practice. It just wasn't providing the kind of care that she wanted to be able to provide for people. So yeah. But she would come home just so frustrated by various things going on. It's like, you know, you have such strong opinions on how people should be treated on how you want this to run, and she was always so proactive about doing that wherever she was.

I said, well, if you can't turn off the care button. You're doing all of that work for somebody else.

Danny: [00:10:01] Yeah.

Jesse: [00:10:02] So why not do all that work for us?

Nicole: [00:10:05] And that was an interesting like thing where he was like, you're either going to have to decide just to shut off and not care and not give an F about

Danny: [00:10:13] anything.

Nicole: [00:10:16] Okay. Then you don't give a fuck about that because he was like, I can't have you continue to come home and be super frustrated about stuff and then not be able to like to make the changes. And so that, that was what was kind of like, Oh gosh, like big, like an epiphany. Like, okay, maybe I can, and then I was like, well, you're going to have to help me then.

And then we had to discuss, are we going to be able to like to work together because we think we can. But when you do it, I mean, there's, that's a whole other ball game, so, but it's worked out well. We haven't gotten divorced yet, so that's great.

Danny: [00:10:55] Check, check that box. You know, the thing that I find exciting and I'd be, I'd love to see your kind of hear your opinion on this, Jesse, having consulted with other companies and, and, and just looking at, you know, the practice that you have.

But also I would say in a generalization of the profession in terms of how grossly we undervalue what we do. You know, like you not being associated with clinical care whatsoever, I think it is an incredibly significant kind of perspective to have. What did you notice? Maybe, it was the mindset, and perhaps it was, you know, certain things that you see with other business owners that were very apparent within the practice that you were like, dude, we have to improve this.

And I've seen this in other businesses or anything that you noticed that was similar.

Jesse: [00:11:34] Yeah. So I think that was a real advantage for us is that, you know, coming into it from a business background with no understanding of your PT profession, not having been through PT school, I was questioning everything.

When Nicola says, Hey, this is what we want to do, and why are we doing it that way?

Danny: [00:11:51] Right.

Jesse: [00:11:52] And you know, a lot of times there's a great reason, and a lot of times that's actually, so one of the things I notice is that that insurance-based mindset has just crept into. Everything in the PT profession, like everything, is geared toward that, that, you know, get people in the door and get them back out.

And you can't have somebody who's here for a long time. If there's something else going on, we got to refer them out immediately back to their doctor. And it's like, well, their doctor's the one who missed this and has been messing this up for years. Why are we sending them, you know, right back to the same person who screwed them up in the first place, at least different locations, or does something else?

So just kind of questioning a lot of that stuff. We went back from an EMR to a paper documentation stuff. Which Nicole was so opposed to, she thought that was a huge step back. And then we sort of sat down and said, well, what are we documenting for? We're not sending this to an insurance company.

We're not trying to justify what we're doing. So why would we, you know, spend all the time when we can develop the paper forms that take two minutes to do and work for us as opposed to doing that for, you know, a 15-minute EMR thing that's insurance-based. So. stuff like that was huge.

And then I think too, just the value, I think you hit the nail on the head with just the value of the profession. And if you look around at like other service-based folks, whether that's dentists or chiropractors or consultants or lawyers, Those professions

Danny: [00:13:19] are

Jesse: [00:13:21] kind of bold and in your face about what they can provide and what their value is, and they're, they're not ashamed or embarrassed to say, Hey, this is what I'm worth.

I went to school for this many years, and you know, I feel like PTs kind of come from that, like almost embarrassed to talk about money. You know, difficult to talk about the value that they provide. But if we look at some of those other professions, it's like, man. A lawyer has no problem telling you that, Hey, it's $400 an hour, and your hours started 10 minutes ago.

Danny: [00:13:53] Think about answering a question for you, and you're going to get, you're going to get a bill for time. And that's just like how they, that's how they make there, make their living. Right. And, and, and you, you're so right about that. And for you guys at this point, you've had many staff come on, and some of them look like they're, you know, relatively newer out of school.

So I feel like that. That same issue is probably very, very prevalent in them. Like how have you guys gone about helping kind of break those false beliefs and develop a better mindset around the practice and their self worth? Yeah,

Nicole: [00:14:20], so right now, we're kind of circling back to that. I thought I did a pretty decent job onboarding, and you know, I think we sometimes forget as practice owners that like

We can't expect us, we can expect a lot from us, from the people that work for us, but we also can't expect them to care as much and know as much about that as we do. You see, we're on all kinds of forums all the time, or reading fucking Sharon's books every minute. Like, that's not right. Frankly, they're not on their list.

You know, it should be, and it might be required reading now, but, but to your point, like that's just not in their mindset. And so we've decided deliberately to start to, bring on younger. A fresher, physical therapist. Mostly so that I can train them in the, in the pelvic physical therapy way, but, and we sort of like, we're like, Oh yeah, your work, where you're working for a cash-based practice.

Like, here's the, here's the spiel that you need to like know that we say, but now we're going circling back. We just got away for a weekend, and we kind of like did a whole, like, like you call a 10,000-foot view of. Like, what's going on, what's working, what's not. And we notice that, that when people are getting asked that question in the treatment room, we're not doing a great job of really, talking about it in the way that we want them to talk about it.

And so I was like, well, the step right before that is, that's me. That's my fault. And so, yeah, we're circling back now, and we are going to have like little weekly, Little training sessions on like the funded fundamentally like what is going on in the cash PT world. Why do we feel personal, like that's a great way to have healthcare administered.

Because. Cause I feel like that needs to be, if not the way that they think in their personal lives, then definitely understand at least why we feel that way for the pelvic health and physical therapy world.

Danny: [00:16:19] Yeah, it's such a, it's such a difficult thing to break too because I think in a lot of ways you don't know what their upbringing was like.

Like them, their parents might've had a lot of issues with money. You know, they might, they might, they may. They may personally have a lot. They may, and it's so hard for somebody if, if. If you, if you hire somebody and they wouldn't be willing to go and seek out a service like that and pay for it themselves, how are they supposed to have an informed conversation with somebody that is in the same position?

Right. And, and we noticed this in particular with our office manager early on, like, it would frustrate us a little bit. And she's like, she's fantastic. She's been those for three years. She's just like such a great fit. But early on, it was something that we just assumed. It wouldn't be hard for her to do.

And, you know, actually, she, she has some excellent advice, cause like, my, she's a much better business owner than me and, you know, she's like, you can't just yell at a plant to grow and it'll become. Like, that's not how it works. Right. Like, you know, yell at the succulent Negro. And the thing is, she's right.

And, and, for me, it just came down to like, breaking down the problem and then trying to develop A framework of how, you know, we can start to change some of that stuff. And it's so much different over, you know, a few, few months to a year. Like it's amazing the difference that they'll make in there, in their mindset.

And, and really in a positive way, going forward. They're associated with money. So have you guys found, you know, any of those things that, in terms of breaking that, in terms of improving their mindset that has worked well for your company?

Nicole: [00:17:39] Yeah, I mean, I feel like that helped a ton, and it's helping.

Or we've already had our first like talking about it and stuff. Then it's like, Oh, now the one thing is, is that we have to like also kind of like you talked about with being individualized, it's like we provide individualized care for our patients. As business owners, we have to

deliver personalized, you know, feedback for our, for our employees too. So, you know, so-and-so over here who has, who comes from this family and whatever, she might have to have a whole different talk to a patient because it's going to be real coming from her. Versus someone over here who maybe didn't come from as, you know, whatever.

Just a background that's different. So they're going to have distinct, she feels, but I think. Setting the foundation for really believing that we are providing a service, that is, is not quote-unquote expensive but valuable for the patient. And we can work with that patient in different ways, to work with their financial situation then.

And I think that that's helpful. And it's been, we've already seen. We see a little bit of an improvement in that and the mindset and stuff.

Danny: [00:18:45] Yeah,

Nicole: [00:18:46] that's helpful. I it can only improve, you know, so

Jesse: [00:18:50] it's a colossal cause we spend a lot more time talking about that with potential patients. And I'm on the training side on the admin side too, whereas you guys have the responsibility to be like great at what you do, as well as having all of these sides so.

Part of it, too, is just kind of creating that culture of has as our front desk people, as our admin staff, see people come through the door. Who has been to four other PTs who have, are flying here from Brazil, from Saudi Arabia, from India, and have been through this for ten years, and all of a sudden they're feeling better after three visits with us?

Like that's where we want to tell those stories as well, not just, you know, here are the facts about cash PPT and why we think it's better and why it works. But when you see that on somebody's face as they walk out for the first time, or have sex with their partner for the first time without paying it forever, or come back with a kid after they weren't able to have sex, and all of a sudden, as I feel, I think those stories are such a massive part of the culture.

And how. We connect with patients and how we can put a face to that cash beauty mindset.

Danny: [00:20:02] Yeah. Well, I think I would love to hear your perspective on the lessons learned from running the front desk of a women's health cast practice for a couple of years. I think that's as a, I mean, the experience level there, there's like, that's thousands of conversations, and you know, so what have you, what have you found in terms of.

You know, you taking that role, which is, which is funny cause it's probably like from what you were doing to that is PR is so different in a lot of ways, but, but doing that and may, it might be the most crucial thing you could have done for the company going forward. So, what did, what did you learn with those conversations about prospective clients that kind of tips one way or in other words, they decided to kind of come in or not.

Jesse: [00:20:42] Yeah, and that's true. And I would recommend for anybody who hasn't had a chance to like get on the phone with people when they call in and just understand like where they're coming from and what their concerns are. And you know, to be honest with you, I was more of a numbers guy and not an empathetic person and figure, but that is so important with.

When people want to call and connect. I love that thing about it being an emotional decision. Like, is this the place that feels right to me? And especially when you're dealing with, you know, embarrassing situations. You know, some people don't want to talk about, they may not want to talk about with a guy

Nicole: [00:21:17] who answers the phone and they're like, what the

Danny: [00:21:18] hell is pelvic sanity?

Nicole: [00:21:24] And then he's so cool. Cause then he's just like, yes, what can we help you with? Is it your enduring symptoms or something that was sexual intercourse? And then he hears the crazy stories, right? Because as soon as you know that like you're, if your front desk person is knowledgeable about the thing that you do, they will quickly forget if it is not like the expectation.

And so I think it helps just to write the book with me. Because I made him learn about the pelvic floor and what it does, and I mean that's like eight years, ten years of me coming back home and being like, dang, that person's like people Cox and GS were on fire left, you know? And he's like, what's the hell's the pupil?

Cox and GS? And I'm like, look at this model. It's like, I didn't decide for life. But yeah, go ahead.

Jesse: [00:22:13] Right? So I had to figure out what the band was and all the rest of that stuff.

Nicole: [00:22:17] It's little stories. So he goes, he goes, what is this band? And I was like, do you mean that it group? He goes, yeah, I guess.

And I was like, I have to go. I have to go with the lessons learned. But

Jesse: [00:22:32] yeah. You know, one of the things that we did is that we called around when we first started to anybody who was big in our kind of pelvic health field and talked to their front desk like we were a prospective patient. And you know, it was just such a turnoff.

When you call somebody, you've gotten up your courage, you may have had this problem for a long time, you haven't been willing to address, and when you call, and you get. You know, a series of numbers you've got to push. And I've, you know, leave a message, or somebody who can't answer a single question is just like, well, do you want to schedule or not?

So really one of the things that we've noticed is the more extended the conversation goes, the better. So, you know, that's connecting with them on some level, like finding out about their history. And that might take, I mean, we have phone calls at the front that are. 20 minutes long. Yeah. It is just willing to put in that time.

Do you know? Cause sometimes it's the first time. Honestly, that they've told their entire story in one go, right? They've had 10-minute sessions with their doctor. But they've never actually gotten to tell anybody their full story. You know, if, if you can do that at the front before they're even coming in like you're creating just such a connection there.

I think the other thing that we've learned is just—being able to control where you want the conversation to go. You know, especially if you get that, you know, that first everybody hates it. That first line is, do you take my insurance? And being able to redirect that and, you know, get them talking about their symptoms.

And one of the things we say in our training for our front desk folks is when people call here, we either want them to come here or to wish they could go here, right? So it's, it's not. You know, not everybody's the right fit. Not everybody, honestly, financially can't afford it for our perspective. Like we do tell people about in-network options if they're insurance-based, and we just let them know that, Hey, if you're not seeing that benefit within the first four to six visits and those first six weeks, you know, don't feel like you're stuck there forever.

But, we feel like with every interaction. And we say the same thing when we interview PTs. we either want somebody to work here or want to work here when they walk out the door. Same thing with prospective patients because you never know if that patient, you know that person who called that their sister, their best friend has a problem.

Hey, I couldn't go there, but these guys were awesome. They were super knowledgeable. They were caring. They followed up with me, you know, three, four weeks later, and just wanted to make sure I was doing well. And from the right place, you know, not, it's great for business to like reach out and touchback with people.

But you know, if people can sense when you're genuine, and you really want them to know and will even say, you know. W I hope we never hear from you again. You know, go for your end network. Try that for six weeks. I hope that you don't have to call us, but don't give up on physical therapy just because you have a bad

Danny: [00:25:21] experience there.

Yeah. It, you know, it's such a good point about being helpful. And, and we, the same thing. Like if somebody's on the fence or they don't come in and our staff, like there are our, our office manager, but she, she, she always jokes, he's like, I'm a PT now. She thinks she's like, I'm basically.

Like, I can fix things, you know, teach me to adrenaline more straight. So, but then, the item is like, we'll send, video, we have a few hundred videos on our YouTube channel we use for homework and based on their symptoms, our office manager will send them a couple of videos and be like, Hey, even if you know you aren't a right fit for us, like, try these, and in the meantime, it should help with what you got going on.

And then, you know, along the way, if you're going somewhere else as it should be, she saved some time regardless. And that alone, like that, has probably. Gotten us more people to end up coming back and see us than anything that we've done, and it's, and it's just like giving a fuck. I mean, honestly, and, and, and I think, I think you're right, the conversation length, I've noticed the same thing.

It's, it's so exciting. And I think in a traditional practice though, they don't want that. They're like, Oh, it's wasted time like either schedule or next person and, and, it's not suitable for that individual. So I think you guys have some. Stable front end systems. Now, once they're there, I'd love to sort of hear about how you guys have kind of orchestrated the experience we will have.

So it seems like you have a kind of unique brand in the way that you, you have your messaging, like how much time have you spent on this is what I want our, our people to experience as they come to the door.

Nicole: [00:26:48] Gosh. Between the two of us, like I feel like that's our entire life. And you know, like, I feel like we're every single day, like coming home with something, gosh, we should tweak that, man.

I said that to this person and dang like if someone says this, we need to do that. Now we're working on like, actually like writing down all that stuff, but we basically, Always just came from a, we just want to be super helpful, and we want people to have. Proper, like expectations. So, I think one of the biggest things with us is that we see people for kind of a long time sometimes, especially when these like chronic pain problems.

So to get, first of all, to understand our PTs to also get out of that like six visits, 12 visits, 24 visits, is like an eternity mindset. But we also want the patient to understand that like. Your first batch of appointments that you schedule is like us figuring you out, and then we will be able to tell you like, how long this is going to take.

And so from an experience standpoint, I think that we have a great blend of, and we've trained a great mix of empathy. And then, authority. So we are the right fit for you because of a, B, C, D. and then we also care just a shit ton about what happens next. Like we want you to come back, like, here's, we have folders for everybody.

That would have like, calm, like the logo on them and stuff. And we like to have. Information, everything that we say to them based on their diagnosis. Because a lot of people don't know what their diagnosis means in the pelvic health worlds, like, what's the badge and miss? Like, what the hell is that?

So, you know, we have like, we've created a whole bunch of fresh, like handouts for them. They have their little. Folder. They have an action plan that we have filled them. We fill out with them. We have goal setting. We have all of that, like in our thing, and then we have them bring back their folder like every time.

So that, number one, it helps us with communication if somebody sees a different therapist, but then also I think that helps the patient have ownership over their plan of care. And they understand what we're doing and why and for how long. And if we change the plan of care, then. We have a conversation with him about it.

We were working on this, and now we're going to move to this because of X, Y, and Z. So I feel like just having honest conversations with people, help them to be more involved in their care. And, and their goals might. Change to the goals changed quite a bit. Right? Cause a lot of times they come in with not even thinking that they can run without pissing themselves.

Right. And so, they are just, and they like, Oh, I wish to be able to like lift my baby out of the thing. But like, were you a runner? Like, now that that's fixed up, like what else? What else do you want to do? You know, do you want to run it. Okay. Do you know? So I feel like that having that conversation with them and just making sure that they know from a physical therapy standpoint, like what we're doing and why.

And, having that ownership, I think the folder stands for like, a lot of just like patient empowerment a little bit on like what they're doing. So that's working out well for us.

Danny: [00:29:59] I don't think I've ever heard anybody like having these, A folder, kind of like flow like that within a practice that I'll talk to.

I think that's really smart and, and just from an education standpoint on the front end is just, I mean, we take for granted, we said, we say it all is information to them and then we're just like, they got it, you know? And I used to think that, and I'm like, they don't have anything. They don't remember shit.

Like, I mean, I think about it like when I go talk to like my CPA, and he's saying stuff to me within five minutes, I'm like. Thinking about something, you know, I was like, all right, whatever, dude, just want to pay as little taxes as legally possible, so let's do that. And you know, so I think if we can take that, that mindset for me, I always ask the same question.

I'm like, okay, before you leave, tell me exactly what you are going to discuss your spouse and get home. Like, what's going on? Tell me that. And if they can't do it, then I'm like, all right, you're not going anywhere. Like, say for a second. I'm interested though, also with a. You guys seem like you do an excellent job with retention and to have continuity and, and working on things longer, more longterm versus just, discharge, discharge, discharge kind of approach traditionally.

And, and I'm sure Jesse, for you, you probably look at that. That's like the dumbest business model, you know, it's like stop people from coming back if they want to go back. So, so how, how have you guys gone about structuring your business in a way that your staff understands that, but also giving people options to, to stay.

Jesse: [00:31:17] Yeah, that's something. You look at it from a business side, and you're saying, man, that's, that's so inefficient. Like you look at a chiropractor model, and they convince you that you need to be in there three times a week for the rest of your life.

Danny: [00:31:27] Right?

Jesse: [00:31:28] I mean, you can debate the ethics of that while you want, but as a business side, like, that's

Danny: [00:31:31] brilliant.

 

Jesse: [00:31:33] so, but yeah, that's, that's a big piece of what we want to do. And then we want to like kind of Nicole was saying is with our staff, I think she does a great job of. Kind of peeling back the layers of the onion, because a lot of times by the time somebody gets to us, they've got years in of having a specific problem, right.

And. You know, we, we address them the first thing that they came in for. But if they've got those underlying goals, it's like, man, how do we uncover those? How do we get them back to doing what they want to do? How do we get them back better than before? If they're doing that stuff, how do we, you know, so one of the things is we kind of look at, you know, when they leave, we want to start decreasing their visits?

The frequency of their visits, but still make sure that they're in our system and coming back. Yeah. So that might be like, Hey, let's schedule something for a month out. You know, you're doing great. You're symptom-free, but we also know you have a history of flaring up. If these things happen, we don't want what we don't want is somebody to go out the door prematurely.

Just barely. Okay. And then two weeks later they do something and now all of a sudden they're thinking, man, PT didn't work. I'm back to square one. Now that's not an advocate in the community for you. That's just somebody who's like, Oh yeah, public. And they were okay. They kind of helped me a bit, I guess.

Yeah. And we want people who are just really comfortable in their home program. They know when to call us back when they need it. They know they can come in for a massage for mindfulness. So kind of easing the transition out. I think it's imperative cause I think that's a mistake that we see a lot with folks or who feel like they're just like cut off and.

Now all of a sudden like life happens, you know, you fall, you know, you do, you work out too hard doing something, and you know, you feel like you're back to square one even if that's not the case. If, if that person feels that way, they're not the ones who are out there in their community on Facebook telling everybody how great pelvic sanity is.

You know, they have, they're ambivalent about you. And, and we want to create that advocate in the community, especially for us, where we're working to raise awareness of this field and, and let people know that there's

Danny: [00:33:43] help out there for them,

Jesse: [00:33:44] for both men and women with all these issues. The best way to do that is to have patients who are just out there.

You know, we've had patients send probably ten patients to us, you know, everybody knows somebody who's dealing with something like this. So how do we make them an advocate when they leave? That's a big, big thing that we think about.

Danny: [00:34:03] Yeah. Do you guys have a system that you've put in place for, you know, referral marketing or any sort of similar structure in place around that?

Or is it mainly, Hey, we're going to fulfill like crazy. You're going to be, and it feels so good. You're not going to be able to shut up about us.

Jesse: [00:34:19] Yeah, so far, it's been the latter. We just want everybody to have such a great experience. We're thinking about right now, making that a little bit more systematic, maybe offering a free massage for stuff like that.

Well, sometimes do Starbucks gift cards for great people, but that's something I think that we can get a little bit more systematic. About, and I think that's a real area of growth for us now that we have enough staff too.

Danny: [00:34:45] Right? Yeah. No, totally. And I think when, you know, when you look at that, it's, it's, I had a mentor tell me, most people, most people's business, you know, lives at like a.

Six, seven, maybe an eight out of 10, like they're, they're good enough to where you know, you're, you'll go, but it's not bad, bad enough where you're, you're going to like, kind of move on to something else. And they'll just stay in business and type of just, just be there. Right. Very few bins are remarkable.

Like, like we're there at this like nine or 10 out of 10 with like everything that they do. And in that case, the people that have experiences with them, they literally. Spew their opinion on everybody about having to see them. And it's such a positive sign whenever, you know, whenever you have, we see that as, as a business.

And, I know that's something for us that we've been working on recently as well, like at something that we just have pinpointed certain people and I'm ha, we've had a lot of success with even looking at like. You know, these are only clients of ours, but they might send people our way. And, and like, a good example is one of them, is, is, our, one of our staff, PTs Jackie, which does women's health stuff as well.

Like, she kind of worked with her on some things and, and she'd sent like five or six people our way, and we're like, okay, what is, what is, what does she like? Like, what's she into? She's like, she likes ice cream. So we ordered this like. Like particular, like grader's ice cream box sent to her house and like she had no idea who it came from either.

We did a lousy job of actually like saying where it was from, and when she came in like, Hey, how's that ice cream? She's like, Oh shit, that was you guys. And she was so excited and like, just, I guess, you know, thankful that we didn't even know that she like ice cream that much. And we sent, sent her a specific kind of.

Thank you gift. And, and I think that approach, and there's probably more systemized ways to go about it, but like just feeling, man, like what does this person like and how can we show that we know them? Not only, but you're also not just, you know, like. Thank them for that, or give them like, you know, something insignificant, but, and it takes a lot of time.

It's hard. But, that's sort of the approach that we've taken. I just think it's such a, and there's so much potential where you can get that right within, within your clients, you know? And, and for you guys, it seems like you've done an excellent job of it. What is your other sort of acquisition streams that you've found that are working for your practice?

Nicole: [00:36:55] Yes. So, just to go a little bit back to like, just keeping P or thanking people. We do thank you cards, thank you cards, and do all that kind of stuff. and then

Jesse: [00:37:07] have a passive-aggressive thank you card or.

Danny: [00:37:12] Who didn't

Jesse: [00:37:13] prefers them, who had to find out about us on their own. Oh, wow. I'm so good. Two different languages.

One is like, Hey, thank you so much for the referral, looking forward to working with you. And then the other one is, Hey, we're going to be fixing your patients. Here we are. You know how to let them know about us a little earlier.

Danny: [00:37:31] I love that.

Nicole: [00:37:34] Come on,

Danny: [00:37:35] dude. I used to do this. I was very aggressive early on with CrossFit, gym owners. And part of it is because I, I was teaching the movement mobility trainer course for them. So I'm like, listen, man, here's the deal. I'm the only person on the East coast that teaches this course. I'm in your city.

If you don't send them to me and they find out that you knew about me, and you didn't send it to me, and then they found it, it found me in a different channel, and they're going to be pissed at you. Hey, might as well just send them to me. That's a good point. Yeah. And I was like, Oh, I don't know. Maybe that's a bit too aggressive, but it seemed to work.

Nicole: [00:38:04] Yeah. Do you know what else we have? We've just cited just deliberately not correctly to market to physicians anymore. You know, I mean, I think that's common. In, in this type of cash-based practice. But we make a huge point to specifically not, I mean, we give them, like maybe once a year, like a Christmas card or like, Hey, we're still here.

So we have touched them. But we do not explicitly try to seek those people out from a hierarchical standpoint. Now what we will do is sometimes be like, Kate, we're looking for people to refer. Or two, why don't you talk to me about your practice and see if it would be a good fit for our patients.

So that's sort of how we're starting to, let more physicians in the area know that we're around. We have gotten excitingly, just a lot more people. We've just been hearing like more that people know who we are now. Finally. So that's been cold. Like. We'll talk to some random person and be like, Oh, you're public, Sandy.

I heard about you from so and so. And we don't know the person who so-and-so, which is super cool. So, but we do a lot of patient education marketing, on our blog, on Instagram, and we do Facebook and Instagram ads for those kinds of things. So that's been a right patient acquisition channel that I never thought I would number one, pay for it, number one, pay anybody else to do.

Cause I was like, what comes on like, I'm not going to be on fricking Instagram every minute. And now I kind of am. But if we've tracked, you know, when people said they, how did you hear about us? I would say, what wouldn't you say? Like 50 or 60% of it is all like either social media or Google.

Danny: [00:39:50] Yeah.

Nicole: [00:39:50] And so it's like they're, it's not physician referral as much anymore, which it shouldn't be. And we have direct access to California, which is helpful. but then, you know, so that's another way that we've just really, we just do, if you only provide patients right information so that you build that trust from that standpoint, then that's like the first, you know, then you have a foundation to get them as patients when something,

Danny: [00:40:13] I think it's great.

I mean, especially, so it sounds like you guys are doing a primarily. Content marketing paid to get in front of the right people in a particular area. Yeah. And so are you guys following up with them in any specific way, or is it mainly just, let's start building the relationship with this? I know they'll have a badass article people have already shared.

They like it a lot. I don't want to get in front of as many people as possible. Is that sort of strategy, or is it after that, then you're retargeting them with some other opportunity to come in and see you guys? We're getting on the phones while your dogs.

Jesse: [00:40:40] Yeah, we're doing retargeting there. One thing that's been pretty successful for us is putting together online, support groups.

So we run an online support group called finding public sanity. So we've got about 500 patients from across the country, across the world who are in there, who are now collaborating that we can kind of moderate and run because of a lot of ours. People end up going on these Facebook groups that are full of doom and gloom, and that's one of the first things we tell people is, you know, get off the internet.

Stop looking at all of the negative stuff out there, because the person who got a great PT from the beginning isn't the one who's sitting on Facebook at

Nicole: [00:41:17] 30 on a Saturday. But then that's helpful to fuel the remote consultation and on an uptown program that we have. So we've seen people from like the kind of a lot of places and your remote consultations too, and that's sort of, that whole funnel is sort of going through that, just providing a good positive place for people to go.

And good positive. Correct information. And then we don't even advertise that much in that group that we even have that. It's just that then they just know who we are and then we, they go to the website and then we have that on there. So

Danny: [00:41:50] I think information is so powerful. You guys have already mentioned stories multiple times like you've said stories a couple of times.

And I think that you know, it's, it's one of the more powerful things that are the powerful story. People remember that. And content in particular, if you can educate somebody, you know, we, we look at that as. I mean, we, we sort of have this unique skill set, but we assume it's not that different.

But in a lot of ways, it is. And. For from a Facebook or Instagram standpoint? I mean, when you look at the numbers on that, my business partner in PT Biz, he has a digital programming company that is all online where they program people that train in their garage. He's run, I mean, he did like, it was over $200,000 in Facebook ads last year.

And what he found was, you know, the. The best return aside from like specific campaigns that are like a direct call to action, and he thought he was just building warm audiences with content ads. But we went back and looked at his content ads. They were, you know, returning somewhere between 50 and a hundred percent of ad span and people joining his program just from sending people to a blog post, no call to action whatsoever.

So excellent content. You've got to try and get that good content in front of as many. Relevant people, you know, that you are positive that you can, and that's probably the most straightforward, most effective digital strategy that somebody could take, without necessarily going through some of the retargeting and things like that.

So obviously, you guys must have excellent content. How does that work with your staff members? Are they part of this as well, or is it mainly you that's kind of put it together.

Nicole: [00:43:13] Yeah, that's a good question. So one of our PTs works for us, like about 25 to 30 patient hours a week. And then the 10 to 1215 other hours is, is social media.

So she is in charge of our pelvic sanity Instagram page. And then I run my own Nicole, Nicole, cozy and DPT. And then we have . the other gals do like we have like little mini-projects that we end up promoting on that. So one of them wrote an ebook on gut health—the other one's writing another ebook on, on birthing positions.

So we have them create content in their downtime when they have a cancellation or a no show. Then we are having them do clinic-based projects like that that we can end up using that content for. what else can we do.

Jesse: [00:43:59] Read a lot of stuff on our blog. We

Danny: [00:44:01] haven't

Nicole: [00:44:01] read a ton of blog stuff. And, and we just sort of research a ton of stuff and then just basically comment on it and what we think about it.

And what was right about that article? What wasn't, Jesse writes a lot of our blog stuff, as well, cause he's like a super excellent writer. It's red. It's why our book, like actually you don't fall asleep reading it is because of him. If I would've written it, I would have been like the worst book ever. But so, he knows a lot about pelvic PT now and then can like.

Yeah. And obviously, he's like has a research background as well, so he can like to look at a research article and then like to ask me about it, and we kind of collaborate on that together. Yes. So that's all of our variety of digital stuff. So right now, we don't have anybody else outside doing that for us. But it is one of those things that we're kind of at the point where it's like, yeah, because it's taking a lot of time.

And with me being so much more busy with like managing people now at the business. We might have to look into how else are we going to structure that so that we can free up some time for us for more of like the business development standpoint. Sure. I'm in training, so that's, that's where kind of our growth pattern is right now, and it's challenging.

It's like a different problem, like every minute.

Danny: [00:45:11] Yeah. Well, I think, I think the main factor is like you guys are doing things to get people in the door. This is, this is a mistake that I see a lot with people who are just starting, and they're just like, okay, I've got my office now. People are going to come.

Do you know? We're like, that's not how it works. You'll sit in that office by herself and be sad like it's going to be good.

Jesse: [00:45:33] The dreams that you build, they will. That's one of the things I think. Again, our different backgrounds help with, is, is kind of filtering

Danny: [00:45:42] your PT content

Jesse: [00:45:44] through somebody who doesn't understand the PT stuff. So in our clinic, that's me, but that's something that can be effective, you know I work with clients all the time.

We do that in like really technical fields. You, no, you think you're explaining it well. And in reality, you are so far over the head of anybody you're talking to. In our book, I gave Nicole an ultimatum. She could only use an anatomical term like one time, right? So it's like you get one use of the word, like Cubo Cox, GS are illegal, toxic gas or any of that stuff.

Well, we'll give it one, but we're not going to be like putting that in every single time because people don't

Danny: [00:46:21] care.

Jesse: [00:46:24] You know what you can do for them? What's, what impacts them. They don't care that, you know.

Nicole: [00:46:30] The biomechanics of the pelvis. Right. I wanted to put that in the book. I'm like, this is so important.

He's like, they don't fucking care. They want to know that you can help their dark paint. Well, okay. Well, there's, there is an anatomy section in there cause I am in anatomy.

Danny: [00:46:45] But yeah,

Nicole: [00:46:46] that's like, it's super helpful to have like somebody. That doesn't have that P T brain, to look at your content and to just look at everything your business.

Danny: [00:46:56] Well, I'm interested in your working relationship because it sounds like you guys kind of like have an exciting back and forth. It seems like, and it looks like you, you're, you've made it work well. How has that transition been like actually going from having these separate careers to then you guys are, you know, working together around each other and, you know, spending so much more time, not just?

Yup. At home or in other things like traveling or doing fun things, but also like and a business and trying to kind of chip away at making this thing work. Yes.

Nicole: [00:47:24] So I mean, I think it's helpful that, you know, in pelvic health, we have private treatment rooms. So I'm, I mean, there's still times of the day where I have to be like, Oh, Hey, how was your morning?

Because I don't see them that often, which I think has been a little bit of our saving grace. But I believe that. First of all, I mean, we just like really respect each other. I mean, I think that that's like a huge piece. And even if our, our ideas clash ever, and sometimes they do. I just feel like we, like, our foundation is so good that we each respect each other's like a commitment to the business, number one, and then each respective expertise, right?

So we kind of just has, like, I'm the ultimate put the hammer down on patient care stuff. So sometimes we have, we deliberately take less money or we look at something like a marketing cost versus a loss to the business, if you know, if that's going to be the thing, if we don't want to sacrifice on patient care, then we're like, okay, well we're going to put that amount that we lose on that patient then in a marketing budget, and.

More of like a marketing cost for us that we're deliberately taking a loss on to provide excellent service. Or sometimes it's like, no, like we can't afford to do that way. How else can we do it so that we balance patient care in the business? So I think it's always like patients first and then we just have a pretty good, separation of expertise.

So that's sort of how we've done it, would you say? That's right?

Jesse: [00:49:01] Yeah. I think that's, you know, we have pretty complementary skill sets, and I do think that when we do clash, which does happen a lot, as I'm sure you guys know,

Danny: [00:49:12] it

Jesse: [00:49:13] tends to use. A better outcome than either of our things alone. The other thing that I feel like is interesting is because we get asked that a lot and you know, there's a lot of, you know, husband, wife, teams doing stuff and you know, how do you work with your spouse?

And it, to me, honestly, I don't know. I think we're substantially better as a couple. I would have had a tough time, like hearing about all of her struggles. You know, as she started up and everything else not being involved, that just seems so difficult to me to, you know, have her come home and say, Hey, we're doing this.

Or, Hey, we lost money today because of this. And, you know, either blaming her or trying to jump in and fix that with not enough information. I would have just driven me nuts if she was doing this on her own. So when people say, you know, how do you work with your spouse? I was like, well, how do you not work with your spouse in some sense?

Like. No, that's, that's our livelihood. That's our lives. That's, you know, her

Danny: [00:50:11] happiness, Lovell

Nicole: [00:50:12] passion. You know,

Jesse: [00:50:13] how, how would I not be involved.

And then if you're going to be involved. For me, it's tough to be involved halfway. Right? I either want to like to know everything and have the whole problem, or you got to disassociate, but you know, if you're going to come home and talk about the business, I'd better know about the company, all the ins and outs and everything else.

So I think it was nice that our, our. Expertise dovetailed that way, but I think regardless, it was essential for us. And that's different, different for everybody, but, you know, just to be involved in what each other are doing is necessary.

Danny: [00:50:47] I, I don't know, I can almost couldn't even imagine not working with me with my spouse.

You know, there's a, there's a huge trust factor there. You're right. You're kind of, and you're working towards the same, the same goal. I think I think the only, and I guess caveat to that would be if people have the same skill sets. Like, if they, if that would be difficult, very tough. And, and I think that in that context, it would maybe not be the best idea.

Versus, you know, Ashley and I, and like, it seems like you guys have just different, different, superpowers and, and that's, that's awesome. And, you know, even like, I know you guys don't have kids yet at this point, but like we do, and like, our kids come into our office and like, seeing, we're like, we're so funny.

Like, they were like. Daddy puts needles in people, and mommy's the boss. That's what they tell people. They were just like, is that all I do? You think that's all I

Nicole: [00:51:36] know.

Danny: [00:51:37] But they do know that you know who's in charge? And I mean, and the other thing too is like, I've fallen into a role of, I know who's better at managing people.

I know who's better at developing operations and systems within the business. And I try my hardest not to seek to wreck that, even though I sort of had this like deep desire to want to rage against the machine, also if it's my own business and my, and my wife. But I push it down, and I do that in other areas in life.

But, she's just better at that than I am. And it's been awesome to see. So, you know, for you guys, I don't know. It's, it's, it's a common trend that I've seen at most people in our mastermind that their spouse and they seem to just, they seem to crush it if they're on the same, same page. So you guys are doing, I

Nicole: [00:52:16] do think too, and it's like important for, I mean, I get, I feel like the PT you get a lot of credit. Like I'm the one who is sort of like the face of the company, but, and so Jesse, I think he does an excellent job of like letting that happen and like not. Where it's like not a competition. It's like we're all like working towards the same goal to like better people's lives.

So it just likes is what it is. So I think that's also really helpful that you're not an arrogant prick,

Danny: [00:52:47] but

Jesse: [00:52:48] she's definitely at the better-looking space of the business. So if we had to pick one that's, that's the meadow.

Danny: [00:52:53] She's the funnier one. I'll give you that. It is weird, like when you, when you do look at particular like a skill or not necessarily skills, but just like personality traits and things that inherently are, you may, you may be better at, you tend to find those roles within it.

And the other thing too, I think with your, if you're thinking about working with your spouse or you are working with your spouse, the ultimate goal of business, in my opinion, is to develop something that, that, you're proud of, but also creates time and financial freedom for you and your family.

Yeah. And who better to create financial and time freedom with the person you want to spend the most time with. Do you know what I mean? Like it would suck if Ashley was working for nonprofits, still getting paid half of what she's worth working every weekend and do, you know, fundraising events. And I'm like, yo dude, let's like go paddleboarding on Wednesday.

And he's like, I can't cause I got to go to the office, you know? And so I think that it frees up time for, for three to spend more meaningful time together.

Nicole: [00:53:42] Totally. Yeah. That's

Danny: [00:53:44] our, that's our thing. Yeah. So what's the, what's the trajectory you want to see with the business? So give me, where do you guys want to be in the next like three to five years with pelvic sanity?

Nicole: [00:53:54] Where do we want to be and go?

Jesse: [00:53:56] You know, that's a tough question we're struggling with where do we want to be in the next like three to six months, just because you know, with how quickly we've been growing. Honestly, it's, it's exceeded any expectation that we had for our first three-year plan.

Yeah. You know, when we got this building, we had three treatment rooms in it, and we thought that that was, I was a business person thought that that was like too much, man, we're paying all this rent. You know, maybe we'll get a second person and that when you signed up to sign a five-year lease

Danny: [00:54:22] to get the build-out,

Jesse: [00:54:24], you know, man, we're paying for all this unused space.

And then, you know, two years later, we're reconfiguring our place to add an extra treatment room. We're renting another office, you know, down. So we can have our massage therapist over there, and our gym can move to give us more treatment rooms here. So for us. I think our immediate goal, and we just kind of set aside a weekend and went down and got a little hotel room and just actually took a huge, like a set of paper and wrote down kind of every aspect of the business and what we want to focus on.

And really for us right now, it's optimizing everything that we've got going. So we want to consolidate our gains, make every stage, of what we do better because I loved what you were saying about. You know, a lot of businesses kind of truck along at a seven out of 10 levels. And what we want is every piece of what we do to be at that nine to 10, but it is more work to go from eight to 10 than it is to go from zero to eight on a lot of things, right?

We realize we are at eight levels for everything that we're doing, but man, just a little improvement in each of those areas. Bringing that from an eight to 10 is really where we need to be. So that's our next, like three to the six-month goal is to optimize. We're bringing on another front desk person, so we'll have complete coverage.

So I don't even have to be here necessarily in person. We're trying to have Nicole drop some of her hours as well cause she's still seeing almost 30 patients a week. And that's, you know, a lag with her admin burden and all the teaching she's doing. Yeah. So really what we want for this next season of what we're doing is

Danny: [00:55:58] just

Jesse: [00:55:59] to have everything running so smoothly and perfectly.

It allows us to go in any direction that we want, whether that's helping PTs or mentoring stuff, whether that's starting a second location, whether that's focusing more on the remote consultation program and the out of town clients that we have. Whatever we want to do. I don't think we necessarily know that yet but to do any of that.

Everything has to be running well. So that's our next, our next step. Yeah.

Nicole: [00:56:25] We pumped the brakes pretty hardcore on, cause everybody was sort of being like, Oh, you guys are expanding. Like, Oh, why don't you do a second location? And that was what prompted that, like a getaway weekend to be like, is that what we want?

Like, let's. Hold up because we have to make sure that we're not just like getting caught in the snowball. It's an awesome snowball to be beyond, but like we have to like control still when that happens. And then just to know, like, we don't want to spread ourselves too thin and all that stuff. So we tried.

We came back and were like, yeah, we're not going to start a second clinic. Great now. And everybody was like, Oh, why not? You guys are fricking busting at the seams. And we're like, yeah, you don't fucking know anything actually about the inner workings of this place. So calm down. So I think it's essential just to like not to get so involved in like the trajectory and want the momentum that some times you have to be okay with pumping the brakes and.

And optimizing what you're currently doing so that then it will free up a bunch of time to do whatever else

Danny: [00:57:27] I think is, I think it's, I mean, I love that. That's the direction you guys are going, I read, I read a book called small giants that, I was about maybe a year ago that really, it talks a lot about what you're talking about currently

Nicole: [00:57:38] reading it right now.

Cause you said that.

Danny: [00:57:40] So I did. Okay. That's right when we talked. Yeah. So, being intentional about like and focusing on being celebrated instead of big. And I think it's easy, especially when you get around other entrepreneurs and they're like, Oh, we had a, you know, 35% growth year over year or whatever. And like we've expanded, so now we've got like whatever, 20 employees and we had 15 last month or whatever, whatever it is.

But with they, it's a vanity number, these gross revenue numbers, these are the size of the company, the, and it's like, and then it starts to dictate what you end up doing outside of the business when it actuality, I mean, really look at. This entity, you've gone out on your own to develop this entity that allows you to live outside of it and impact people in a way that you want to live this different life.

And. Not letting it take over your life. Can, I think it'd be hard, cause I've been in the same position where we're like, all right, we're going to expand to another location. And, I've had people offer to buy our practice and franchise it. And I'm like, dude, I don't want that. Like, I'm not interested in it, you know?

And, and yeah, I mean, money's not a driving factor for me. And, and I think finding out like, what is like, like for, for art, for me, it's, it's about, Impact, and it's about achievement. Like I just like to move on to the next thing. And that doesn't necessarily have to be more, it just better is an achievement.

So I, I love the fact that you guys are going that route. I think it's so similar to, to kind of what we're doing and, and it's refreshing to hear that because, for the most part, people are just like, yeah, I want to. I want to have like 10 locations. It's like, why?

Nicole: [00:59:05] I think that's a big question, right? Because we're already making, I mean, we were making like the gross from a gross revenue standpoint, we're making way more money than we ever thought we could.

And so now it's like, Ooh, this is kind of cool. Now we can decide. I'd make a deliberate decision about how we're going to reinvest—that into our either business or our lives or both or the PTs that we have. Or like, what are we, what are we doing, and who do we want to impact the most? And it could keep patients at the forefront, and now we're re, we feel very responsible for our employees too.

We want to make them have the best, like experience the best life. Like, so we're, we're excited now to like be able to decide what to do instead of just. Yeah.

Jesse: [00:59:47] Colin with the next steps, too, like our roles are changing so much. So from the outside, it kind of seems like, Oh, you must be doing the same thing.

Like, Oh, you've been there for three years. And it's like, well, no. Like Nicole is moving so much more into the, how do I train our people? Well, you know, that matters so much more than at the very beginning when it was just us. You know, in this big empty room, and she was the only person treating. Like what she does on a day to day basis is entirely different than it was three years ago.

And that's becoming the same for me as well as I'm doing more, you know, training of our front staff and overseeing staff. And so some of that is just figuring out like, Hey, what part of that do we love? What part of that do we not like and want to do less of? Because it's, it's just always in motion too.

So I think that's another piece that as you grow, and again, always formidable problems to have, but. Figuring out what of those new responsibilities like you enjoy, what are you good at, and what of those, you know, would you want to get off your plate and where do we want to focus? You know, going forward.

So Nicole is like an excellent teacher. She's done a lot of continuing education courses. She's flying off Straya to teach some stuff over there. And you know, maybe that ends up being something that's really. You know, becomes a more significant part of what she does. You know, that's again, part of that like, Hey, let's pump the brakes and stop and think about like, what part of this do we enjoy and how do we do more of that?

Danny: [01:01:12] Yeah. Yeah. It's, it's so cool, man. I have a, and I have a, a mentor that is, he's just funny, like the way he said stop. He's like, you know, being like real, true wealth is being able to hang out with people that you like, do the shit that you enjoy and have flexibility and say over what you do on a day to day basis and, and, and, and his, his view of being riches.

Being able to, or order an appetizer at a restaurant like that was like his, like, I can order an appetizer at a restaurant and not get water. That was, and this guy is worth a lot of money. And as I started laughing, I was like, dude, we never ordered an appetizer when I was a kid. Like, and if I try to get like sweet tea or something like that, I would have been knocked over out of my seat by my nose, my parents probably, you know what I mean?

So it's just funny. Would be perspective of like, you know what? Yeah, what do you want? What's, what's wealth? What's success? Like, it's so subjective. It's so individual. So, yeah, you guys seem like you have your shit together. It's Austin. So where, where can people, Learn more about what you're doing.

Check out the practice. Maybe reach out to you. You know, if they're wanting to engage on anything after listening to podcasts. Absolutely.

Nicole: [01:02:13] So, our website is pelvicsanity.com. We are on Instagram @pelvicsanity. I'm on Instagram @NicoleCozineDPT. Yeah, you can email at Nicole

@Pelvic Sanity.com, and we love to hear from everybody, so if anybody has any questions, we're kind of open books about it. So yeah, we'd love to connect.

Danny: [01:02:35] This has been awesome. I just want to thank you guys for your time. I mean, I know you're busy, you've got a lot of stuff going on and, and have an hour to be able to kind of,

chat with you guys and learn a little bit more about your business and, and not, no exaggeration, definitely one of my favorite podcasts that I've done, you know, in the last few years. So, anyway, this has been a lot of fun. I think people are going to enjoy it. And, I just want to say, you know, I appreciate your time.

Thanks so much for coming on and guys, I hope you like this as much as, as I do, feel free to reach out to me to reach out to them. And, I hope this inspires you to like, if it's not just women's health, it's a, it's a niche. Like if you have an answer and a desire to. Want to be the world's greatest, whatever, you know, women's health, PT, golf, PT, whatever practitioner, you know, you might be like, strive to do that, and then your business, you know, we'll, we'll, we'll grow with you and you'll have success.

So, as always, guys, thanks for listening to the PT entrepreneur podcast. We'll catch you next time.

Do you want more cash, PT, biz help? If so, go 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 Finsurancebook.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.

https://www.physicaltherapybiz.com/