E829 | The #1 Reason Cash-Based Clinics Plateau At 30K/Month

Breaking the $30K Plateau: Why Growth Stalls and How to Scale Smart

If your clinic is stuck between $20K–$30K per month in revenue, you're not alone—and you're definitely not broken. This is one of the most common plateaus we see among cash-based and hybrid clinic owners. It’s frustrating, confusing, and often makes you question if you’re doing something wrong.

Here’s the truth: this stage isn’t a failure. It’s a natural part of the growth cycle. But breaking through it? That takes a real shift—from being a great provider to becoming a strong business owner.

Why the Plateau Happens

At around $20K/month, most solo clinicians are maxed out. They’re doing everything—treating, admin, marketing—and they’ve likely built a solid lifestyle business. But the moment they try to grow past themselves by adding space, staff, or systems, the game changes.

Growth adds overhead: rent, salaries, utilities, insurance. And often, that means net profit dips while gross revenue climbs. That’s expected. But what’s not expected? Hiring a new provider and realizing they can’t fill—or retain—their schedule the way you did.

The Real Problem: The Eval Hamster Wheel

Here’s the trap: you bring on a new provider, pass them your new evaluations, and they handle care. But after they treat and discharge, there’s no follow-up. No performance care. No long-term plan. And now you’re on the hook to find 15–20 new patients for them every single month just to keep them busy.

That’s the eval hamster wheel—and it’s exhausting.

You can’t scale sustainably if you constantly need more evals. The fix? You must build a system of recurring services that give people a reason to stay. Health goals. Performance training. Wellness. Prevention. Those are the real levers for scale.

Train Your Team to Sell Transformation

Your new hire likely came from an insurance-based background. They know how to treat and discharge—not how to resell transformation. You have to teach them how to build long-term plans, connect with patients on goals, and offer continuity beyond the initial issue.

If done right, this builds a snowball effect where each provider only needs 6–8 new patients per month because the rest of their schedule is full of happy, long-term clients. This is how you break the $30K wall.

What This Phase Feels Like

It’s hard. You’re working more, profiting less, and questioning everything. You’re hiring, training, still treating, and trying to build systems. But just like growing pains, this is a necessary discomfort. You’re moving from a lifestyle business to a real company—one that can generate non-active income and eventually run without you in the day-to-day.

Final Thought

If you’re stuck in that $25K–$30K/month zone and can’t figure out how to grow past it, it’s not because you lack leads or clinical skills. It’s because your business model is still built around discharge, not long-term transformation.

The good news? You can fix it. Train your team. Build systems. Focus on retention. And lean into the type of business that creates freedom—not burnout.

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

Podcast Transcript

Danny: 

[00:00:00] If your clinic is stuck between 20 and $30,000 a month in revenue, you're not alone. This is an area where we see clinics plateau all the time, and I can tell you this much, it's not because you don't have enough Instagram followers. I'm Danny Matta, founder of PT Biz, and over the last 10 years I've started clinics, I've sold clinics, and I've helped over a thousand cash and higher based clinicians.

Start, grow, and even sell their own clinics as well. And this is an area which we consider a growth cycle phase in a business where we see clinicians get stuck all the time. So we're gonna talk about why are clinics getting stuck between 20 and $30,000 in gross revenue. So. Let's define that real quick.

That's how much money your business is making before you take out any expenses overhead, what you pay yourself, any of that, right? So this is just the dollars that the business is making. So why are we seeing clinicians and businesses get stuck at this 20 to $30,000 mark and what can you do about it? So.

Let's talk about this phase for a second. So, for [00:01:00] most, uh, clinicians by themself, they're gonna be able to generate around $20,000 in revenue individually, uh, if they're doing everything else in their business, right? It depends on what you're charging. It depends on how much volume you're seeing. Many factors, but this is basically where we see people settle in.

Um, and if you decide that you just want to have a lifestyle business and this is all you're gonna do, it's not a bad place to get stuck, honestly. Like you're still gonna make more money than you would, uh, working for somebody else. You're gonna have the tax advantages of a business. You're gonna have time, flexibility.

You're gonna work a lot. Um, if you're seeing that much volume. But even still, uh, it can be a great place to just settle in and stay there as a lifestyle business. When people go to scale past themself, this is what we consider the first growth cycle. So when we look at a growth cycle, growth cycles are where you're gonna see an increase in your gross revenue.

So how much money the business is making. But you're gonna see a drop in the net profit for a period of time. Uh, it's. Typically [00:02:00] not permanent. I would suck if it was, but it's going to be somewhat temporary as you bring on additional overhead. So here's what happens here. So at this sort of $20,000 mark, you're going from usually a very small lien footprint with maybe a subleased office.

Maybe you have an administrative assistant that's virtual, or maybe not. You know, maybe you're doing a lot of things on your own. So now all of a sudden you're moving into a space where you can. Bring on other providers. You know, you have more space for people to be seen in person. You're growing this into what looks like a real business, like a true business that your family could walk into and say, oh shit, this is a real business.

It's not just this little office in the corner of a gym anymore. And with that. Comes more overhead in the space. It comes with, you know, more rent. It comes with utilities, it comes with more insurance, and it comes with salaries of people that you're going to employ. So this $30,000 mark, this sort of like, you know, plateau that we see people get stuck at.

There's a couple [00:03:00] reasons why. And one of those. Is that it's very natural for, uh, the, the owner of the business, the clinician that started the business to hire somebody. Uh, and then. They slide new evaluations over to this new provider. They're not taking as money themself. You, you really, I mean, naturally would have to do this because as the owner, you're busy doing many other things and your time is really better.

Uh, used to drive new business into, into the clinic, to systemize the business, to train your staff, to to improve the operations of everything, to improve the customer experience, to make it a better business. But in the meantime, you're now moving people over to a clinician who is obviously relatively new to your business, and because of that, uh, they're not gonna be as good at the business model that you're running.

They're gonna need training, they're gonna make mistakes. They're not gonna do as good a job of [00:04:00] converting your sales cycle. Um, and one of the biggest things that we see that drives the lack of being able to break through this. Is the provider that you bring on and the way in which they work with people.

And I would say the biggest mistake that, that we tend to see is, and this doesn't show up immediately, this typically takes about six months for people to really realize this, is that there is a lack of recurring visits happening with the new provider. One of the things that PTs are bad at is sales, which is ironic because we're actually really naturally good at sales.

Uh, we just don't know it. Sales really is just understanding somebody's problem and providing a solution to that right, and gaining trust with people. We're great at that. One thing we're really bad at is giving people a reason to come back because we haven't really been taught that in school. We haven't really learned that in, if you go, if you come from an in-network clinic, they're probably not doing much as [00:05:00] far as recurring services are concerned.

They're playing a evaluation treat discharge game. Right. A different game than we have to play in a cash base or hybrid clinic. So here's what happens. You bring somebody on, you slide evaluations over to that person. And maybe they're okay at front end conversion to a plan of care. So getting people to commit to solving a, a problem with this new staff member, you work on that, which is getting people to commit to a plan of care that starts to improve.

You wanna see that be 70 plus percent of people coming in, uh, solving a problem. Most of these are gonna be chronic or, uh, acute on sort of subacute or chronic issues. And. Once you solve that, you completely forget about the recurring side, which is a secondary sale that happens. So you're focused on solving the front end problem, which is conversion to plan of care, getting somebody comfortable with your sales process, all the systems in your business.

And along the way, they've done a terrible job typically of giving people a reason to come back [00:06:00] of. Actually having this secondary sale of a recurring service, which is solving long-term problems, working on, uh, prevention, performance, health and wellness goals, all kinds of things that we can help people with in a really profound way.

But this person you hired May A not know how to do that, or B, know how to sell that. So here's what happens. You go from getting people in the door. You have a lot of people that are coming back to see you. So you don't need as many evaluations. Your schedule snowballs, and because of that, you can now hire this other person.

But when you bring this other person on, they struggle with sales. You focus on the front end. Eventually you realize that there is a recurring revenue sort of snowball effect that's not happening. 'cause they're not reselling people, people are not coming back. And because of that, they need more and more and more evaluations.

And the more evaluations that you have to find each month, the worse it is to run your business. Like if you had to imagine that you had to find one of new eval per provider that you had, let's say you had [00:07:00] five providers that you were, that you were employing and you only had to find one every single month.

Think about the pressure of that versus having to find 20 for those five people. So now you have to, you have to find five versus a hundred new evaluations. Which of these do you think is gonna be a more effective business model? Which of these do you think is gonna be a less, uh, stressful business model for you to run?

This is why recurring revenue is so important. This is why giving people a reason to stick around and solve long-term problems is so important because it allows the snowball effect to happen. So the reason that people get stuck here primarily is the fact that you are hiring people that you're training and they're still playing a discharge game.

They're, they're, they're playing an eval, you know, solve problem, discharge game versus an eval solve problem. Solve a secondary problem or create a performance, uh, option that people can now hit goals they didn't even know they could do physically. That that is what's a really cool thing to do. And it's a [00:08:00] shame whenever people miss out on that because we don't know how to sell that as a profession.

'cause we don't learn that in traditional clinics. But what that also does is it decreases your need for finding new patients. So if you can get your new patient need per provider down to eight per person or so, somewhere in that range, that's a fantastic place to be because that means that they are snowballing their schedule with people that are sticking around.

And that is where we break through this $30,000 range, which so, so many people get stuck at. Because what happens is you're basically splitting the same amount of lead flow, maybe more because you're spending more time on marketing, but your schedule, you're still only seeing a few of evals. 'cause you have so many people coming back, the other person is seeing 20 evals plus every single month and they're just discharging everybody.

And every month you have to find more and more people for them. And it feels like you're on this. Terrible hamster wheel of like new evaluations that you just never have enough of. It seems like. And it's because you are not giving people a reason to stick around or your folks don't know how to sell.

How [00:09:00] to keep people around. Recurring services are so important, and I can tell you we have worked with over a thousand clinicians that have started and grown practices. There is a distinct difference between the speed at which somebody can grow a practice when they have a solid recurring sales system and a reason for people to stick around that they love and they want to continue to do that, and people that do not.

The start is relatively the same. 'cause usually founders are pretty good at this, whether they actually know it or not. People like them, they wanna stick around with them. They, they do a good job of it, but as soon as they bring somebody else on, they don't function in the same role. And it is very frustrating.

And you'll have turnover and you'll say, man, this person's just not able to keep people around. And what's up with it? It's because you haven't actually implemented a recurring service system, any sort of ongoing sales system that keeps people in a recurring. Basis to snowball that person's schedule and take the pressure off of the new evaluation side of marketing and allow you to really snowball schedules and hire more people.

Because if, if I have to find 20 patients for this person versus if I'm in, uh, in, in a [00:10:00] clinic where I only have to find half that many, 10, I'm gonna be able to hire that second staff clinician much faster. That third staff clinician much faster. And this phase kind of sucks. I'm gonna be honest with you.

We call it a growth phase for a reason. Have you ever had growing pains? Do you have kids that are growing quickly, like they're in pain, their shins hurt 'cause their bones are growing so fast, right? Like that is what happens in a growth phase. It kind of hurts because. It's one of the lower profit stages of a business.

You go from you doing everything, high profit margins to then you grow into a fixed space facility, overhead staff, everything, and now your profit margins shrink considerably and all of a sudden people are like, oh shit, what happened? What happened to this profitable business? Well, you turn it from a lifestyle business.

To what would be considered a true business, and you're working towards non-active revenue on your behalf, meaning you're gonna get to a point where you're not the one fulfilling everything and you have true [00:11:00] non-active or passive revenue that can come from that business, which means it's valuable, which means that if you get hurt, money still comes in.

It's the hit by the bus test. It's a really important transition to make if you wanna have a real business. But to get there, you gotta go through this real shit growth phase and that growth phase where a lot of people get stuck because they do not have people coming back and they're constantly having to fight to get more and more and more evals when they really need to be focused on long-term, keeping people around and solving problems.

Because imagine this, if every single person that came to see you, I'll see you again. 20 new patients a month. If every person came back twice a month forever. And they just wanted to come in and work with you, so that first month you have 20 the next month. You got 40, you know, then it doubles again, then it doubles again, and it doubles again, and pretty soon, within a couple months, you have to hire somebody.

That's the recurring side of things. That's the ongoing perpetual snowball effect that happens when you have people that are filling your schedule that are not new evaluations. Not to say that you don't need new [00:12:00] evaluations, but you just don't want to be as dependent on it, because if you are, you're gonna get stuck in this phase and you're gonna be sliding people over to a staff member that's just.

They're playing a different game. They're evaluating and discharging, and you are not playing that game. If you have a cash-based performance clinic like we work with, you're playing more of a lifetime value. Long-term, solve long-term problems. Be an advocate for these people long-term with health, be their human body consultant long-term, you know, help them achieve these fantastic goals that they have.

And, and that is a fantastic game to play, a fun game to, to, to be a part of, a great place to be as a clinician, you just gotta learn how to sell it. So if you're stuck in this phase. And you feel like you keep bumping up against this 25 to kind of $30,000 range and you don't know what to do about it, we can help you with that.

Head to physical therapy biz.com, check out what we got going on. We help people go through this phase all the time. Again, like I said, I think this is the the toughest business phase that people face in these clinics. I'm not gonna tell you it's easy. It's not. There's a lot of things that you have to do here.

You're gonna be time poor for a while. You're building systems, you're hiring people, you're training people, you're still [00:13:00] seeing patients. It's a tough phase to go through, but. Business is tough. What do you expect? It's not easy. That's how, that's what keeps people out too. But you gotta learn how to become a great business owner.

Track the right track, uh, track the right things, train the right people, uh, follow up with people the right way to continually give them the mentorship and leadership that they need. Hire effectively so you're not just getting the wrong people in the door and improve your marketing at the same time.

And if you do those things. You are gonna snowball your clinic really quickly. You're gonna break through this stage much faster than other people that are not doing this correctly and not get kind of stuck in this limbo of this, uh, unprofitable, uh, clinic phase that so many people are, are stuck in for a long period of time, and you're gonna be able to grow that true business of your dreams much, much faster.

So as always, thank you so much for watching and listening, and I'll catch you on the next one.