E22 | Leon Knight

Are you sick of being micromanaged in a insurance based P.T. clinic? Do you want more time with your patients? My friend Leon Knight did as well and broke away from the traditional physical therapy practice to open his own cash based practice, Movement Solutions (now The Performance Doc), in Charlotte.

He's know happier and more successful than ever. On Episode 22of The P.T. Entrepreneur Podcast Leon gives me all the details on how he started his practice and what he is doing to make it successful now.

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Episode Transcription:

Danny: [00:00:00] What's going on guys, Doc Danny here with the PT Entrepreneur Podcast and I'm excited to have my boy from Charlotte, North Carolina, Dr. Leon Knight, on today, to talk about his practice, Movement Solutions Physical Therapy, give you guys an idea of what he's doing and hopefully you can model after that and find success as he has.

So, Leon, and thanks so much for jumping on the podcast with me.

Leon: [00:01:52] Danny, thanks for having me. Glad to be here.

Danny: [00:01:54] Yeah, no, this is going to be fun. I, I think, people are going to learn a lot from this one. And, and I love what you guys are doing it movements, solutions. To give me a little background about, you know, what that is, what's moving solution?

What are you guys trying to do with that practice?

Leon: [00:02:07] So, with movement solutions, I look at it as an opportunity for patients who have maybe been to a physical therapist or a couple of different practices. And we're weren't able to get the results that they wanted for whatever reason, lack of time, or just, just results, just not being what they wanted.

So, a lot of the patients that I see are coming in off of referral or almost like their last chance to improve their condition. It almost gives me the previous option, you know, and we kind of go from there. So my goal is always just to focus on assessing, assessing, and then maybe from there and being able to figure out exactly what's going on.

Danny: [00:02:48] So she guys are like, the cleanup guys ran it. And, sadly, we ended up having to do that,

Leon: [00:02:54] I think that that's the way it is like you. So it's kind of like, let's clean up and maybe just change their opinion about physical therapy so that they don't think we can never get better with physical therapy.

Well,

Danny: [00:03:05] you know, with, with you, so movement solutions, physical therapy, but how, how much have you found. The fact that if you just say movement solutions, it doesn't sound like physical therapy, right? Like, it's, it's, you know, kind of agnostic to anything at this point. So it's like, okay, this is movement solutions.

What does that mean? And, and with us, you know, our, my practice is athletes potential, like, it's so vague on purpose because I didn't want to like necessarily just push physical therapy so much. How many people do you see that, you know, it's kind of this changing their perspective on what you're doing and, and also letting them know that not all, you know, physical therapists are the same.

Leon: [00:03:40] Yeah, so I think, a good number of that higher level athletes, the CrossFitters, the weightlifters, and some professional players as well have, when they've come in, I've worked with them. They realize that I'm just trying to figure out what is the best way for them. To be better at what they do.

So that's the solution aspect and whether it's moving a certain way or changing, changing what they are doing and tweaking so that they can perform even better. So I think that has changed their perception as to physical therapy. I only have to go when I'm hurt or, if I do go, it's going to be just the mundane exercise.

They don't understand what I'm doing as an athlete. Do you know? Right?

Danny: [00:04:19] I get that a lot, man. And where you know, people, it's almost more comfortable for us when they have a terrible experience at another physical therapist. And have you noticed that? It's like, you know, Oh, I want this place. And they gave me this handout of some like a 75-year-old woman doing leg presses, and I can back squat like 400 pounds, you know, so why, why am I doing this crap?

Do you know? And, and it makes it easier for us. How many people do you have that come in to see you that is just like disgruntled from another experience? And you know, once they get one visit with you, they realize it's different.

Leon: [00:04:48] I'd say a good number of them cause I give free consultations so.

Because I'm cash bays, I think the free 30-minute consultation just to sit down and talk with them and learn what did not work, why they're frustrated, why they are looking elsewhere. And usually, during that assessment or consultation, I try to get my hands on them a little bit and figure out how it can help them and try to get some small change here or there so that they may realize, Oh, this is different.

He, so he has SAS. He did some things that I never had, experienced somewhere else. So that's how I try to set myself apart from session one.

Danny: [00:05:19] Well, let's come back to that in a second cause I'm interested in what about that, assessment approach. Tell me this, give me, give me the origin story of movement solutions.

So, coming out of school, did you work anywhere else for us, you know, and what made you decide to go into private practice?

Leon: [00:05:30] Okay. if you don't mind, I'm going to backtrack just a little bit. Second, this is a second career for me. I graduated with a business degree in 2005 and then. I worked a little bit and finance, doing kind of like financial advisor things and individual consulting and wasn't enjoying it.

So around 2009, when this recession had hit and was the full floor, full force, I was laid off, but before I was laid off, I started pursuing physical therapy, seeing what kind of things that I wanted, what kind of things that, it would take. So such as pre-recs and so forth for me to jump back into school.

So, I did that and took the prereqs and went into grad school in 12, 2012, and New York medical college. And then, after I graduated, I spent a year working in a regular physical therapy clinic. And then after that, I went on my own. So the set up of your

Danny: [00:06:23] practice now is, is it, within it, preexisting gym?

It looks like it is. I was trying to get a feel for it.

Leon: [00:06:28] That's right. So I have my own office space. I'm within a gym, and I have access to the gym. If I need to use higher-level equipment, so such as squat, rags, whatever the case may be, treadmills. But, within the office, just the table, all the equipment that I needed, kettlebells and different things and we just go to work.

Danny: [00:06:48] So a year out from school, you decided, you know what? Screw this man. I don't like what I'm doing. I want to do my own thing. What, what, what was the driving kind of the main factor for you to decide, I don't want to work in this practice? I'm assuming it was probably insurance-based practice. I want to do my own thing and eventually take that step forward.

Leon: [00:07:09] That's a good question. It's similar to your first podcast when you kind of described it as a story, where you mentioned how just wasn't, a fit in terms of only so much structure, the micromanaging, and, you know, just it was too rigid. So, same, same thing, but on top of that, it's about that. I wasn't able to grow in different ways just with being in that particular setting.

So I figured there's gotta be more potential for me to do things differently. And the fact that I was already taking continuing education courses I've had made—nine courses since graduating 15. So, I mean, I was getting my mentorship that way, so I didn't feel like I was going to miss that component.

So, along with other mentors that I had, I said, well, you know, I feel competent now. I have some of the reps they experienced with working with the patients cause it was a volume play. So I got a chance to, you know, get the hands-on experience, which was great. And you know, but after that, I felt it was time.

It was time to make that move. So I started seeking out different gems and see what it would cost for me just to set up a table and have a little bit of space. And that's all it came down to. And then I have to find this place where I'm at now.

Danny: [00:08:23] So. With a, you know, respects to how you started this, did, did you say, you know, all right, I'm going all-in from, from day one.

And I liked, I liked the metaphor for like, burn the ships, you know, there's no turning back, which is what I did, which may be not as the best option for everybody, but, or did you, did you work part-time doing something else and, and kind of set this up on the side until it grew a little bit and then, you know, transitioned to

Leon: [00:08:46] full time.

Right. So that's, first of all, I want to say that's impressive that you did that. You know, I always, I know it's not often,

Danny: [00:08:54] I just feel like, I feel like sometimes entrepreneurs, we're just dumb. We don't really, and we don't realize just how risky we are. We are some times,

Leon: [00:09:02] right, right. No. I was watching enough to.

So my fiance at the time, she was a physical therapist, and she had a steady income at in skilled nursing facility. So, what I did was I picked up PR and work at a hospital

Danny: [00:09:16] to kind of

Leon: [00:09:18] know,

but that kind of helped me along the way. And then, I started growing a little bit and, and that, I think that's what helped. And then, I have to really admit that while you're in the gym, there's such a great opportunity for you not just to be overbearing, but to be there as a resource and that resource turn into

Danny: [00:09:43] Oh, a hundred percent man.

I mean, we'll think about it. There's a reason why professional teams, you don't have these cohorts of, you know, strength staff, medical providers, and psychologists, all kinds of stuff, you know, and. They're right there for, you know, access. And if you look at some of these gyms that have more significant populations, I mean, you can extrapolate that on a smaller scale.

You know, w within that gym. So the gym process, you find this location, right? So how many places did you go to, what was, what was that process like? I think this is one of the things that scare people off from pursuing this, you know, type of clinic environment. You know, from the beginning.

Leon: [00:10:21] Right? So I just started emailing as many gems as possible that I thought would work in terms of the location space and just almost the overall theme and environment there. And so I would do, I did that, and I will give some, some responses and I would meet them in person and just kind of look around and see what kind of space that they had available.

And then from there, Discuss kind of, you know, how much per month and what they're looking for and just, there's different, what I learned, there's this other kind of negotiations or different types of leasing options that, they offer, or you can offer. And then I just kind of found which one worked best for me.

Danny: [00:11:00] So what type of, gym are you in

Leon: [00:11:02] currently? So I'm in a normal amount. It's a, it's privately owned gym, but it's pretty spacious. And, They were in a location that is pretty, I wouldn't say a fluent, but not necessarily best what you have to have to be a cash-based on some learning.

But, it's an excellent location as up and coming, and it's growing. And, also I was looking for how much competition is around, and there wasn't much competition. Oh, I think it, there's one other physical therapy practice, but not saying they're not a competition, just a matter of, it wasn't like four or five on the block.

Do you know what I mean?

Danny: [00:11:37] Totally. And so the process for you, whenever you finally sat down with this gym owner and, and you know, tried to negotiate what would be best for you, so what, what was that like? What did you guys end up agreeing on in terms of structure, whether it be percentage or sublease on a set amount and duration of time that would be, so how was that kind of leasing process.

Leon: [00:11:58] Right. So again, going back to something you said, on your Instagram, which is so true, make sure you have coaches along the way. Pay for them their courses, but they're worth it. And that to me, you get more out of that as opposed to a course. So, fast-forwarding to that question, one of my coaches mentioned, see if you can get a flat rate.

And she kind of gave me ideas on how much. You should be, you know, they should be offering or requesting, I should say. And so I already had that in mind. And so when I went in, he actually, the owner blew my mind with the generosity and his willingness to kind of bring me along. So he said, okay, for the first three months, $300 a month.

So I signed a 300, three, a three-month lease, and then he said. After the three months, we'll see how you're doing. You can say, yes, I want to stay in. Yes, I, you know, no, I don't. It's not working. And then after that, it'll go up to $600 a month for the next three. And then from there I was, it was by like December or January, of this year.

I felt good about it, and I was growing. And I thought that was sustainable. So I signed a year lease for $800 a month, and that's the splat, you know, that's pay 800, and that's it. And so that's how it worked for me. And I think, you know, there are different ways for people to do it, but that's, I think, kind of ideal with

Danny: [00:13:23] a flat rate.

I agree. you know, I, I had a. Then, I was on the duck legs podcast and had those guys asked me about, you know, lease options and stuff. And one of the everyday things that people, I think to find as less intimidating is just to pay a percentage of each person that they see in their office, which I believe to be just such an awful idea because the reality is, you know, for you in a, in a booming cash-based practice within that gym, I mean, you can be highly profitable.

And the last thing I want is that business owner, no one how much money I'm making. You know, because then he's going to want more of it, you know, naturally, or he's going to get upset if he realizes our profit margins are way better, you know? So, you know, at going forward, is there a good relationship with that gym owner?

Do you think someone was going to say they're in the longterm? Are you looking at potentially even springboarding this into a standalone location at some point? Like what's what, what's the future of movement solutions for you? Where would you like to see yourself in the next like kind of one to three years?

Leon: [00:14:20] That's a good question. I've already kind of considered, whether it, the next step, and the next step for me, I think, would be to open up in another gym location. And the only reason why I would go that route is because of the overhead. It is just keeping in mind that always wants to minimize overhead. And so, I think.

I am starting up another place, similar to the way I did where the equipment is there for you, and you only need minimal stuff. We'll help bring it along and then either have my wife take over in the new low in a location that I'm at now, and I start from scratch again in a new place or have someone else take over where I'm at.

And then my wife and I open up a new location together somewhere in a bigger space. That, that's kind of what I'm leaning towards. Just not sure yet. But, eventually, I will have to start considering that I don't think the stand-alone is where I want to go. Quite yet.

Danny: [00:15:13] So let's talk about cutting your, your week at this point in the structure of it.

Because if you're at the point where you're kind of even thinking about going to another location and potentially hiring, you know, you're getting pretty busy. So what's, what's an average week look like for you guys? And is, are thede hour long visits? Are these 30-minute visits? You know, what, what do you typically see in volume-wise in a week?

Leon: [00:15:34] So they're about, they're an hour-long visit. And I'm roughly around 20 to 21 pages or sessions I should say, a week. And so I'll sort of approximately about four to five visits a day. And to me, that's where I want to be ultimately is about 25 consistently. Right. That was my goal a year out. Now I'll just pass a year anniversary, but, So, with that being said, now I'm starting to consider some other options because, to me, growth wouldn't be, see more patients, more in our growth would be, okay, how do I like it? How do I have someone on board to help me understand more people wants an hour?

Danny: [00:16:16] Well, you also brought up an exciting kind of Potential good or bad thing with the spec that your spouse, you know, working, working together with your spouse should say is potentially an option. Are you guys already working together, or is it something you're just possibly looking at doing because she wants to move towards a model like this as well?

Leon: [00:16:35] Well, she, so she helps out, but she still has a full-time job. There's a, and there's a little, Add as the law sometimes should add where she's pregnant, and she's due in November. Nice. So that changes everything because

Danny: [00:16:49] boy or girl, you find out yet

Leon: [00:16:50] I'm having a boy.

Danny: [00:16:51] Oh, you're such a stud.

Leon: [00:16:53] I don't know about that.

Danny: [00:16:54] You validated it. Mirror. It takes a man to make a man. As I said, I've got a son so that I can say that, but no, that's awesome. It does change things. Yeah, that's a good point. And we're bringing up some real-life shit, man. This isn't, and this isn't, you know, this isn't on paper. We're real people, and you're taking a real risk because you're trying to do, you know, you're trying to do something great.

You're trying to, you're trying to build a place where your son can then go, you know, and hang out and see like, you know, this is my dad's place. How awesome is that? So you, you know, so. You guys have a couple of layers of complexity now. So your wife's working with you, you're about to have a baby. How's that relationship between you and your wife?

As not husband and wife, but as business partners?

Leon: [00:17:34] He's been accommodating. And to me, I always believe, find someone that can compliment you well, right? So when it comes to organization, the accounting and making sure all the I's are dotted and T's across, that's her. Just give me a table and a patient, and that's, that's my role, you know?

So, kind of going off that, I think ultimately we're going to have to, I think it will help if she works part-time. So ideally we're thinking work part-time, maybe with, the hospital and possibly get benefits, but then the other half you can have the flexibility come as you go, go in and leave as you go.

It is working with me to see the other. Five to 10 that I may not be able to see it by kind of don't hire anyone. And to me, that'll be the group. That, to me, is ideal growth before we hire someone else.

Danny: [00:18:23] Now, how much happier are you working in this model than you were working in the mill?

Leon: [00:18:29] Oh man, I can't believe you asked that question.

I, I, it's tremendous because don't get me wrong. I work harder. Totally Haven clothes. Right. And, but I enjoy it. I enjoy it. I 'll sum it up like this. So when I use where I used to work, I would, I couldn't, you know, I w I would be conscious of the time that in terms of lunch, like I, I'd be, I can't say when in lunch was coming.

Like it's 10 minutes away if it's an hour away. Right. Whereas here, I'm working through lunch and not even thinking about lunch. Just from the fact that there are so many things, so many things to do, but it's not, it's not. It's not laborsome. It's like, Oh, I've got to do this. I got that. And then by the time you know you this, Oh wait, let me just stop and grab something to eat.

So that's just a difference in, and settings for sure.

Danny: [00:19:18] So it's, I like to put it this way. It's like, and it's the difference between looking forward to lunch and lunch is just a burden. He has like, gosh, shit, man, and I have to eat lunch. You know, like if you are enjoying what you're doing, it's crazy how much faster your day goes.

You know how much, how much more energy you get during the day versus people that are just if you're staring at the clock and you're thinking, awesome, I can't wait to get off a word like you're doing the wrong thing. Do you know? I agree. Well, all right, so four, four you guys are at, you know, you got. Yeah, 20, 21 people a week.

Well, what's your strategy to get more people, man? I mean, like what's, what have you found that works? W what, what, what are your, your goals kind of going forward to get to that, to get that 25 and then more if you're going to bring out another provider, like where are you going to try to focus on?

Leon: [00:20:05] Right.

So I think the biggest bang for my buck was developing relationships. So I have a couple of partnerships or alliances as I say with a weightlifting club and then another personal training gym as well. And then also, what I've been doing is Instagram, I think surprisingly has been helpful as well.

And I think it's just now starting to pay dividends. I'm almost, I forgot who mentioned this to me, another mentor, but he was saying, don't be afraid to plant seeds. Okay. Because if you plant seeds, don't plant them and don't expect them to grow right in front of your eyes. I want you to plant them, but realize that eventually, they'll become, and then you're going to be happy that you planted those seeds.

So, for instance, I wouldn't, in the beginning, I was doing seminars. I did a couple of workshops here and there, and again, I didn't get any patients. They ask questions at the end, but I didn't get any patients. But now that one of the partnerships that I have with the gym was from a seminar, and I see all their weightlifters now, as opposed to if I didn't get into, you know, having that mindset as to I'm giving a free seminar. I didn't get anything from it immediately.

So, I think that has helped. And then the next step is just kind of figuring out, as you probably know. This marketing thing is trial and error. I've tried Facebook, I've attempted to Google ad words. I'm trying another campaign, but, to me, the name of mouth recently has been just dominating ref, the source for me.

Well, word of

Danny: [00:21:36] mouth is big for sure. And you know, and, and see that you've been in practice for a year, roughly. Right. So that, that just snowballs on itself too, to the point where, where the more people that you see, the newer, you know, new patients that you see, the more they go and tell people, you know, the more those people tell people.

And now you have this. This kind of consistent word of mouth referral basis, but, but you're right. I think that's, and I'm looking at the marketing can be tough. This is something that we've spent a lot of time and money on, over the last three years, to dial in. And, yeah, there's no. There's no, as a set road for everybody either.

I think this was, can be frustrating, with marketing. But I, you know, when you look at growth and growth to multiple providers, there has to be some kind of multi-faceted approach to be able to get people in the door. And word of mouth has to be one of those. But the social media and digital side thing is also massive.

So with you, you do an excellent job with Instagram, you've got quite a few Instagram followers. But also there's a lot of engagement, right? Cause there's plenty of people that have a decent amount of following on Instagram or whatever another platform. But there's, there's just not as much engagement. I think commitment is vital to look at.

So what, what was your strategy with that, and what have you found to be most successful within Instagram in particular?

Leon: [00:22:48] Well, so in the beginning, Instagram was this. An afterthought. I just only to rejoin social media. In January 2016, I didn't have Facebook, and I had an Instagram, nothing. And then, but I, I knew I was going to start to make that jump.

And so I said, Hey, you have to be in it to win it, or you have to be out of sight, out of mind. So I gotta at least be present. So, it wasn't until October, where I honed in what my message was, what I wanted to be, which was simply. Hey, physical therapists are not just the protocol, physical therapy, physical therapists that you are used to.

And so those that are scared, they're going to tell, you know not to do this and are going to, are not equipped to see an athlete. So my goal was just to use that platform to show that, Hey, it doesn't take six weeks to get results. And then also the variety and in the individual type of approach.

That will set me apart from any other clinic that is just kind of given everyone banded ER at the door or stuff like that. Do you know what I mean? So I think that's what I mean.

Danny: [00:23:58] Okay. With you talking about the Instagram message, so with your message, is that, is that targeted specifically to your ideal client?

Or are you trying to just kind of? Educate people on the fact that what you guys are is, is different and that could potentially reach people that don't even or wouldn't ever also come and work

Leon: [00:24:19] with you. That's a good question. I think ultimately, my goal is to show, you know, how we're different.

But also if you notice most of the patients on there, they're smiling. And so people go on to physical therapy usually are going for something that. It's bobbing them. That is, it's cramping their lifestyle that, you know, it's changing the quality of life. So the fact that most of my videos patients are showing, and engagement and enthusiasm, like enthusiasm, like they're enthusiastic about just being there and working towards a common goal.

That is the message that I want to say that I kind of want to get across and that you can get that here and movement solutions or just in general. Don't stop until you find something similar to that wherever you are. Cause there are physical therapy clinics out there that can give you that type of family atmosphere and that individualized care.

So you

Danny: [00:25:16] guys are in-network with Medicare. And one thing about Medicare is, Yeah. So none of those people are going to be on Instagram. Right? So like there's, you know, it's unlikely that my grandfather, who's 93 is going to pick up the phone and look at Instagram and then have no idea what that even is.

So, right. So when you look at that population in particular, because this kind of network with Medicare, but out of the system with, other, insurance is, it's, it's becoming more popular, what's been your strategy. With getting more Medicare patients. And I guess initially what was, what was your rationale for wanting to go in-network with Medicare?

Leon: [00:25:48] Okay, so, so the first strategy was just the gym. The reason why I liked the gym so much was that they have like a silver sneakers program, so technically, their insurance companies will pay for them. Well or spend the majority of what the amount is, or sometimes they don't pay anything for their membership.

So they have this massive population who consistently go to classes. So, you know, bar class or yoga class, they are consistent, and they are there all the time. So that's the first thing I was like, okay, well. Let me introduce myself through a balanced seminar. So that's what I did. And then, I got a chance to meet a lot of them.

And, that's how that took off. And then also on top of that, right beside the gym, there's, basically a gate at senior community, pretty big community. So, that's again, another way for me to get my name out. And then, with the doctors, I'm starting to be close, like the closest for. Some doctors are in the area and to refer to.

So that's another way that it has built up for me. And then, the second question, I'm like, what was the same problem?

Danny: [00:26:54] Oh, just, you know, how are you getting these Medicare patients? And I guess you kind of already answered some of that.

Leon: [00:26:59] Okay. Yeah. So, a lot of referrals, to be honest with you, a lot of referrals in.

And I think, even though they don't have, you know, not all of their friends are at the gym. So I'm getting referrals from, you know, getting referrals that lead to people that are not necessarily gym members. And so that's how that's what has helped me. I haven't recently gone out and did a seminar to like a nursing home or anything like that, but that's probably on the horizon soon.

Danny: [00:27:25] So what, what percent of your schedule is Medicare versus non-Medicare?

Leon: [00:27:31] It would probably be about 40%

Danny: [00:27:34] 40% Medicare.

Leon: [00:27:36] Medicare? Yes.

Danny: [00:27:37] How big of a pain in the ass is it to deal with? the Medicare kind of process verse, well, obviously the cash is straightforward, but how much of your time does that

Leon: [00:27:46] take up.

Surprisingly, not too much. It was a learning curve in the beginning. But, I have a billing company that helps me. So what I do is I, I make sure they get a referral and, you know, doctor's prescription, and then I load everything. I'll make sure I get all the paperwork, functional measure score, and stuff like that.

And then, I submit that and upload it onto my database. And then from there. My billing company takes a certain percentage, reasonable, very reasonable company. And then I just keep up with the sessions. After every ten visits, then we make sure we make a progress note and get assigned. But for the most part, that's not too bad.

Let me tell you what's been challenging is a little bit of the submitting out of network, out of network bills. So, for instance, I've, I'm out of the system. In the beginning, I was. But then I started to say, okay, I'm leaving some people on the table who just don't want to submit it to their insurance, my invoice.

So, but they have out of network benefits, and they have a relatively manageable deductible, not the 6,000 or $9,000 deductible. So I've been submitting that insurance. I'm famous for that, and it's been helpful for them so that that learning curve took more than Medicare.

Danny: [00:29:00] Now you've been doing that yourself, or you're, you're outsourcing this to this same billing company.

Leon: [00:29:07] Same billing company. Yes.

Danny: [00:29:09] So what's been, what's been a more of an issue with you for that, if you're outsourcing is what, what is it that you had such a hard time with or still struggle with?

Leon: [00:29:17] Well, some of these insurance companies will say, you have to get authorization from them before they sign on to let you continue to, so you send, you send an authorization form along with the evaluation, and they'll sometimes determine how many they think you should get.

Or, you know, stuff like that. And so you can be burned by just seeing them for ten visits. Then they say, well, you know, we're all going to pay for two, or we don't think this is, go ahead.

Danny: [00:29:44] Yeah, no, I mean, it sounds like a rig for sure. A big frustration. So how many, how many of those people that you're submitting for, do you think that you'd lose them if, if you, if you didn't do that and, you know, is it, do you think it's worth your time?

Cause that sounds very frustrating.

Leon: [00:30:02] I probably wouldn't lose, and when I say buy suffer, they were coming with everyone that I have now has was happening to me before I started submitting theirs out of network benefits. What I would lose is the people that have been coming twice a week for the out of network benefits because then they will only pay me.

You know, once a week and they'll play my cash rate once a week as opposed to being able to come twice, and they don't have to pay much out of pocket

Danny: [00:30:28] now. And as far as your rate goes, so how much do you guys charge per session and, you know, is how, is that in regards to what Medicare is reimbursed, reimbursing, for you, is it similar or is it Wade, is it way different?

Cause it's a big chunk of your schedule—40 %.

Leon: [00:30:43] Right? So one 20 is per session, and then Medicare, along with the supplemental insurance, and most people have paid. I roughly get about, I get about a hundred dollars, so it's not as much of a drop. And that's why I took, that's why I went that route because I'm just in-network with Medicare.

And people who have a supplement. So what you'll run into is a lot of people, sometimes there are some people out there that have Medicare advantage plans and what that is, you have to be in-network with their advantage plans for the most part. So, you know, like United healthcare has a Medicare advantage plan and Edna, so you have to sign up with them to be in-network with them.

So you may only get 70 bucks total or 65, and I don't want to go that route. So that's, I don't get anything less than a hundred dollars.

Danny: [00:31:31] Yeah, that's crazy, man. I mean, you know, Medicare is something that we, at our practice, we are, don't even, we don't also mess with, if somebody of that age, we just basically, we have to tell them to go somewhere else.

We in, in, in, some of it just has to do with, we're not a, you know, even a, what do you call it? Opted out provider or whatever. So but we also are in like Medicare, you know, ho hub like you are, it sounds like you're surrounded by. That population. And, and not only that, but man, it's, you know, I feel like that population could utilize the approach that, you know, you and I take so, so much better than, being pawned off on somebody, you know, like a high school student to teach them how to do, you know, whatever, TheraBand, tricep press downs, you know, and, and you do, you know, do something more skilled.

You know, so from a, from the standpoint of Medicare and your, your. Cash schedule. You know, is that the ratio you want to try to keep percentage-wise, or would you prefer to drive more towards less Medicare, you know, more cash.

Leon: [00:32:31], and just to clarify, it does fluctuate. Like, 30% or 40%, like it's, it stays between 30 and 40 and never is half or more than half.

But, I'm always trying to, You know, to be honest with you right now, I'm okay with just, you know, whatever. You know, I just love to work with patients that are active and motivated. I don't care what age, because they are going to get results. They're going to get better. That combination of active and motivated are the patients that you and I want because they're going to reinforce outside of the session, and they're going to do what it takes to get better.

And so I think that to me. Is the P is the ideal patient for me. And whether it's more Medicare, whether it's more out of network, or not, I don't know work, but just the, you know, healthy population, it doesn't matter as much to me because it's not too much of a difference. In terms of pricing, it is if they, if I saw 80% of Medicare, but, at this stage I, I'm just trying to open the door right now and just continue and then eventually probably will be a little bit more selective in that sense.

If I get too busy. Earlier,

Danny: [00:33:38] you brought something up that I thought was interesting and talking about coaches and mentors, and in like this whole process can be very, confusing at some times. There's, there are so many ways to do things. When you look at starting a business or growing a business, like, for instance, we're having this conversation about Medicare, and do I do that?

Do I not do that? How do I structure my schedule? How do I do this and that, you know, like? There are so many different things that you need to know, and questions answered, and you can learn all this stuff the hard way. You can also learn this way via mentors and coaches. So you've, you've already kind of talked about the fact that you've utilized coaching in the past or currently are.

What type of coaches have you worked with, and what's been your experience with, you know, business mentorship or coaching?

Leon: [00:34:20] Well. Of course, I've worked with people who have their cash-based practice. I'm all ready, so I'm Aaron LeBauer, a perfect guy.

I'm about an hour and a half or so or less from him. And so, when I signed on for his class, cash, PT, cash base PT blueprint, He allowed, I asked him, could I just shadow for a day. So I went for a day, and kind of shadow looked at his operation and learned more from him. You know, in person. I thought that was this, and that was monumental because.

It's one thing to get like webinars of how to do something, but just to see it operate and see little things that he did. That made it just a smooth and very, very, just excellent customer experience. And that's what I was looking for. And then I'm; also, I read like Jarod Carter, in Texas. I've read him, his cash base, kind of like a manual.

And then, had. Another physical therapist who has a regular practice in New York. He was also CII, would throw ideas at him. He would, you know, cause I will always debating about this Medicare or what my rate should be. And he, he broke it down to figure out what your break-even point is. Yeah. I was like, man, you know, take me back to the business school.

But he's right. Cause he, in the beginning, most people are going to try to say, you know, try to take anything they can get. Oh, you pay me $20, that's fine. Just come in the door. Right. But you got to find your break-even point. And then from there, you have to figure out what you're willing to take. But never accept anything less than that.

At least. So, I thought that was interesting. And then one thing I would recommend is. Get someone outside of the business as well. And so a good friend of mine is a patient and kind of like you, you know, you speak the patients, they're willing to give you advice. Just ask them, you know, and just kind of learn what they do.

Well, he's a very successful business owner. He does like a. He's almost like a rent a center kind of with furniture, but his Carolina rent to own. And he always gives me ideas on that. I didn't think about that or, you know, have you thought about it this way? And then he's a real big numbers guy. And so, he helps out that way too.

So just those little things, putting it all together, you realize what is, you know, what will be best for you—but having that. Mentorship is great. I love the fact that you make mistakes.

Danny: [00:36:45] Well, you also bring up the fact that you've, you know, you've paid for fast-tracking certain things, right? So like, I think it's straightforward for people to think, Oh, if I take, if I just take this whatever course, I'll be better PT, and then, you know, people will come to see me more.

When in actuality you're, you know, you're probably. Good enough. If you're thinking about opening your practice, you probably are better than average, to begin with, right? So what, but what we don't think about is the fact that the differentiating factor in many people succeeds in private practice is a fact of how savvy they are from a business standpoint.

And that you can learn as well and reinvest in that. But it's scarce. For PTs to look at it that way. Cause maybe they don't get CES for it. You know, so for, for you, in this past year, have you found yourself spending more time trying to learn about business or physical therapy or wherever your, you know, strength coach, physical therapy, hybrid?

Leon: [00:37:47] more about business because I took the majority of my classes. During that first year. So I've only made two to 3 cents. Well, yeah, two to 3 cents. I'm coming, like starting my practice. So yeah. The rest of it has been learning from people just less than let's have coffee or reading and stuff like that.

And, and I tell you, most people describe, most people state that you have to. This economy is now experienced-based. It's not about like, and it's not always about your results. Sometimes people come in and say as they wouldn't even listen to me, they, I didn't yet, they didn't know my goals. They just went ahead and told me, and these are the exercises you need to do your week.

I'm thinking, man, there is more to it than that. So, you know, I had to learn how to develop the brand, how to improve this family atmosphere. And, this environment is conducive to improvement. You know what? I'm conditioned. I became in with,

Danny: [00:38:49] it's such a good point, man. And, you know, I, I just was on a podcast previous to you and, and, the guy we were chatting with, you know, we talked quite a bit about customer experience and, how important it is.

And what's interesting is. People that you don't get a lot of pleasant experiences in health care. In most cases, they're terrible. Do you know? Like who looks forward to going to the doctor? Do you know? I don't think most people like that, but I can tell you. You know, when people come to see us, man, we, we, we have a good time with them.

We're joking with them. You know, like, I liked it. I want to think that, you know, we make their day a little bit better when they do come to see us, even though they are dinged up, and they're dealing with something. You know, it's, it's fun, man. And we get to, and we get to know him on the level of, not just their name, but like the name of their kids and what their kids are doing.

And if they've got a French bulldog that, you know, his name, whatever Spanky and they're like, you know, like we. We, we learn that stuff. And it's so cool because we get to develop these relationships and they enjoy the experience. And I almost feel like if we didn't even touch them there, you know, we just sat there and talked to them for an hour, like they would still leave and B, they'd be like, damn, that was awesome.

Because, you know, because they have to have an opportunity to express like, what their frustrations are and, and that experience is vast. So is there anything you found. That you tried to make sure it's consistent from a customer experience standpoint, you know, over and over again, you know, within your patient visit, for that, you know, whatever current visit they have with you,

Leon: [00:40:17] I have to do, I have to learn this story, right?

Every patient I know, they say, you gotta when you're assessed, you're supposed to learn this story. I'm trying to figure out the story, but even before I get to that, I try to figure out, you know, why they come in. How long have you been dealing with it? You know, what has it prevented them from doing, like, all these things are just, so crucial for me to learn because that's how I connect to them.

On a level other than just, you know, I'm the therapist I am to jump, you know, almost. I want to connect with them as a, on a personal level, so that I can say, if I had that injury, I would feel the same way, and then how I would feel. And then that, to me, creates that. That, that relationship. So now they have you developed the trust and that bond, and you can go from there, but you can be the most excellent therapist, but the person doesn't trust you or feel comfortable with you.

They're not going to buy it.

Danny: [00:41:10] So big, man. That's huge. So I got two more questions for you. Real, real short ones, but I think super, applicable to our listener base is number one, is give me one book that you've read, you know, since you've kind of started your practice that you feel like other PTs that are wanting to go to this kind of entrepreneurship route started practice or currently have a method that you, you've just benefited a ton from.

Leon: [00:41:34] I think, you know, you don't, you don't have to do it, but I did it, and it's the, I kind of, I'm, I'm losing, I'm losing it is the, I think it's how to develop a business plan. It's the business plan book. I forgot exactly the,

Danny: [00:41:50] I've heard of this one. What's it called? The business plan book.

Leon: [00:41:53] The not book, but I think it's just like the business plan.

Okay. You just, it kind of guides you along how to develop your business plan. And what that did for me was it structured my thoughts, and it helped me develop a plan and a focus, right? So, in the beginning, when I did it, people would ask me, so what kind of business do you want? Like, or w, you know, what, what makes you different?

And I was like, ah, and I'm not, I'm not. You know, I'm not sure. I just want my practice. Right. Then I started, when I read this book, it kind of guides you along on how to develop what was going to distinguish you, write out your pros and cons, your competitive advantage. And, and then also how to look at your competitors and so forth.

And that structured me and how to allow me to kind of hone in. So I would start with that just to kind of get some structure. It doesn't have to be a thorough business plan but begins there.

Danny: [00:42:47] So what's one app or kind of software piece that you're using in your practice right now that you think is just great, and everybody should use?

Leon: [00:42:56] I'm not as big on the apps. Honestly, I, I'm. When I first started dry needling, I would use the trigger points app. But right now, I don't, and I don't use the app too many apps. But I have been using, like, I use the podcast app, a little bit now, but I'm not to the point where. I'm on the phone a lot.

Unfortunately. I need to work on that.

Danny: [00:43:17] Well, I tell you that I think that trigger point app is, is money in the bank, dude, whenever you're trying to describe referral patterns for dry needling, I still use that. You know, somebody comes in, they're like, why do you want to stick a needle in my TFL? My side of my knee hurts.

And I'm like, well, let me show you. Yeah. And it's just a good visual. So I think that's an excellent app. The trigger, the trigger point app, I believe, is what it's called.

Leon: [00:43:37] Yes.

Danny: [00:43:38] Yeah, that was great. Well, Leon, man, this was awesome. I enjoyed this conversation. Thank you so much for your time. Before we let you jump off, where can people reach you if they have questions or maybe just want to connect with you and kind, kind of, I figured out what you guys are doing and you know, see if there's a way where they can provide some value to you as well.

Leon: [00:43:54] Sure. Thanks. But thanks for having me. First of all, I enjoyed it as well. So I have an Instagram account. Yeah, definitely.

Danny: [00:44:01] Check that out. The Instagram is fantastic. Check his Instagram out.

Leon: [00:44:03]  Thank you. Yeah, @theperformancedoc. And so, that's an Instagram account. And then you can email me at dr

[email protected] If you have any questions and just, you know. Want to run things by me or something like that, I'd be more than happy to answer them and, and look forward to them. Actually.

Danny: [00:44:34] No, that's, that's great, man.

It's love, just like, you know, the ability to be approachable and, and you know, and guys, if you're listening to this. I'm sure some of you have emailed me, and we get back to you. And you know, I'm certainly going to do the same thing. It's just we just try to try to help people as much as we can. And it's, it's fantastic as you do that, it only comes back, you know, tenfold in terms of, you know, your success.

So, Leon, it's so refreshing to hear what you guys are doing. I just, I love to learn from other practice owners and see the success that they're having. I think it gives the people that listen to this podcast a lot of confidence and to know that it's not just me. You see, I'm not an outlier. It's not just whoever else, you know, Jared Carter that you've probably heard before.

You know, it's, there's plenty of people in the country right now that are, that is, they're saying, you know, I don't want to, I want to work in a PT mill. You know, I just wish I want to see people the way that I felt like I should have when I graduate from school and, and there, and they're doing it.

So, man, thank you so much for your time. We do appreciate it. Thank

you

Leon: [00:45:25] I look forward to the next time

Danny: [00:45:27] you got it. You guys. This is the PT Entrepreneur Podcast, and we'll talk to you next time.