E202 | What To Do When Your Practice Flatlines

Something you will experience or have already experienced as an owner of your own practice is your patient volume and revenue flatlining.  There are several reasons this stage happens and on today's episode I address them.

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Episode Transcription:

Danny: Hey, what's going on, everybody? Doc Danny here with the PT Entrepreneur Podcast.  Today I want to get into a question that I got from one of our mastermind members. As soon as I talked to him on the phone, and it's a, I think it's a common problem. It's something that's, that a lot of people will go through or currently going through any time they start their own business, in particular a service-based business.

And I want to kind of give or shit shed a little bit of light on, The challenges that the people go through and how to, how to deal with some of that. Now, if you're thinking about starting your practice, or if you've already started your training, I highly recommend you head over to F insurance book.com.

Go pick up a copy of my, of my book. I give you pretty much everything I've learned over the last five years in terms of running a cash-based practice, and it's free. All I have to do is pay for shipping and handling it, and I send it to you. So if you haven't got a copy of it yet, go and get that. If you have, and you've been hitting me up on Instagram, let me know.

You're reading it. That's awesome. I appreciate it, and it still blows me away that, you know, we've had a few thousand people. Get a book, in particular, a book called fuck insurance and read it, which is pretty amazing to me. So I appreciate everybody that has done that. Hopefully, the book has been helpful, and you've gotten a lot out of it.

So back to the question. Thus, the problem that we got to summarize, is, Hey, I feel like everything that I'm doing, it is not working, and that, that I'm scrambling to try to get. New patients into my practice and I flatlined a little bit in terms of volume and revenue, and things just don't seem like they're working the way that I want them to work.

And for many of us, and if you've never started a business this, this is going to be sort of hard to relate to, I think because. Well, I don't know, maybe imagine like if you go to a new school, I've been to a lot of new schools, so this is probably the closest representation that I can think of that, that I've gone through, besides, starting a business.

But, you know, for me, when I would go to a new school. It was always the first few days sucked. You know, sometimes it was longer than that. It's usually the first few months tended to suck depending on the location or, you know, where, where we would, where we would move to. And a lot of us, cause you didn't know anybody, you know, he didn't know anybody.

Nobody knew, knew you, nobody knew anything about you. What. You know, you're interested in or what your personality was like, or why they might even want to be associated with you. Right. And in a lot of ways, you have to prove that to people. And one of the ways that, that, my brother and I, in particular, found out that we could do that was by playing sports.

So we would try hard in any sport that, that we were, they were in, and it depends on the season, you know, so if we knew, okay, we're moving essay in January. We got to go ahead and start, practicing and getting better baseball because we knew as soon as we got there, you know, baseball was going to start fairly soon, and that was our opportunity to get on a team and get looped into a group of people where we can begin to developing friends much, much more comfortable.

Right? If we moved over the summer, we would start. We are getting ready for the football season. We knew when we got there, and we'd start getting involved in team workouts. We'd meet people over the summer, and then we'd get looped into a support system. Which is the best way to go in a new place now for this person in particular, the part of the frustration, I think part of the challenge is the fact that he moved from an area where he's from originally.

After graduating from PT school to an area that he is not from where he wanted to live. So it was a lifestyle, you know, move basically in terms of moving to a city where he wanted to live. Which is great, you know, and, and that's, I was told one time by, by my mentor, Kelly Straddie said, Hey, there's no luck in where you live.

You pick where you want to go. It's up to you, but you've got to make it work whenever you get there. And for this person. You know, moving to a new location and then starting a service-based business, a cash-based practice, that's difficult, that's a challenging undertaking. I've gone through it. There's plenty of people in our mastermind that have gone through it, and I can tell you at this point now, having worked with several people that we have that have started practices or are grown practices, if you start a method in an area where you're from, it helps tremendously.

Now that may not be the place where you want to be. And that's total, that's fine. All I'm saying is if you start a business, a service-based business in particular, in a place where you have a lot of connections, you have a lot of people that know who you are and know that you've started this business and that, that want to see you be successful, they will recommend you to people.

And, and right, maybe those people are not all physicians that are going to refer you a ton of people or, or something like that. Or, you know. Trainers that are going to send you a bunch of people, but it's still people that are talking about you and helps a lot with local trust and local relationship development.

So when you move somewhere where you're not from, it makes it that much harder. And the challenge is, how do you, how do you get somebody to like you faster? That's hard, you know because trust is built slowly. Relationships are built slowly in most cases. And when you try to rush a relationship, it's, it's, it's typically going to turn into you ruining that relationship.

Because the easiest way to get somebody to dislike you is to try to get them to like you faster, and the idea of patients with that, with local marketing, can be really. Challenging for four people and frustrating for people. Because imagine this, you know this, I know this. This person is an excellent provider, excellent PT, right?

And if you knew, man, I'm good at this thing, I can help people. But you weren't able to share that with as many people as you wanted to. It would be frustrating, you know, for you, what if you had like the world's most delicious cookie, you know? And, and you want to share this cookie with everybody, eh, but.

Nobody knew who you were or why they would want to eat your cookie. And, and, and you know, you're giving out free samples. Maybe that's the best way to do it with a cookie, but probably not physical therapy. And it's frustrating because you know what you do is, is good and that you can help people. But it's a, and it's a massive hit to your confidence when you know, people are just not, they're just unsure of you because you're not.

Someone that they know or has been vetted by somebody else, you know, at that point. So the process can be prolonged. And, and it's also a place where I see most people that are going to give up and not follow through with really committing to a successful practice. Most of those people will drop off in this phase right here in this phase where, you know, they're six to 12 months in, they.

Hit a point where they, they, they hit a little bit of a wall. They get frustrated, and they start to lose confidence. They sort of get down to themselves. I've been there, I've thought to myself, like, man, am I not as good clinically as I think I am? Like I thought I was pretty good at this. Like I seem to be getting good results for other people, but I just don't seem to be getting as many people as I need to really grow this business and sustain this business as fast as I wanted it to happen.

You know, like, we all want, we all want these things to happen as quickly as humanly possible. It's just, and we wanted it to happen yesterday. And patients are robust. Patients are adamant in particular when your livelihood is based on, you know, you see patients. You need to see more patients grow your revenue and sustain, you know, your, your business, which in the early stages is, you know, fragile.

A few bad months, it can be tough on competence, but also your cash flow. Do you know? So I would say for me in this position, whenever I was there, what I found was. Developing relationships slowly was the only way to do that and not try to do it faster. And I've ruined relationships with people in the same capacity being very cavalier about why they wouldn't want to send somebody my way or, or, or if they didn't.

You know what might happen. And being able just to show that you have a unique skill set that you understand that target audience that you're working with—and being able to be okay with meeting with somebody, asking for nothing in return. You know, showing up, being involved in their community, and starting to build you, your reputation organically is.

Huge. Now in the meantime, there are a few things you can do if you're in the stage where you're, you know, a little bit slow. And also a caveat to this, some of this is seasonal. Okay. So. For some of you that are in practice at this point, especially early on, you're going to be more susceptible to these slight changes, in the, in the season.

And what we've found over the last five years is this pattern in Atlanta, at least it's not the same everywhere. But at least in Atlanta, it's January, February, March. We're usually very, very busy. April is a little bit slower because that's when spring break is. So there's often about two weeks there where the spring break is kind of split up between the different counties.

So we have people that are out of town. It's a little bit slower. May is usually really, really busy. June, July. Slows down a little bit because of summer travel. So we'll have a Lowell over the summer. August, everybody's back school, starting back up. Everybody's got their routine back. And so August, September, October are busy.

And then November it starts to slow down in December is usually very slow because, you know, our, our staff is traveling. People are traveling that we're working with. It's the holidays, you know, so it's almost like a. 60 70% month for us based on the number of li people, people taking leave that we have, us not being there.

But you know what it's like to do, we're going to enjoy time with our family and so is everybody else. So understand. That's going to happen, but, but if you don't know, that's going to happen and you're just in it, and all of a sudden you see your revenue or your, your volume flatline or drop a little bit, you're like, Oh crap, what the heck is going on?

Do you know? And it's straightforward to jump to conclusions and scrambled to try to, you know, get. Take every angle to get new business that you possibly can and then put yourself in a very reactive place, which is not the place that other people want to be or are surrounded by. Right? So like nobody wants to be around people that are being very reactive and scrambling, and you can tell if somebody has a lot of urgencies and something that they're doing, and then it's a little bit, it's like.

Trying to figure out why the heck are they. So, you know, adamant about this happening right away. And if it can be very off-putting in particular and trying to develop these local relationships. So just to understand what's with some of that seasonality, it is what it is. You can't change that until you start to until you begin to.

Develop better, ongoing recurring revenue models within your practice. That's the best way to stabilize it. But when you're just getting started, you don't have the volume to be able to develop these recurring models because you don't, you don't have enough people that you've seen. To stabilize your, your practice.

You know, you need somewhere in the range of probably around a hundred people, to where you have a stable baseline of people that you can use regularly and regularly help to stabilize your, your practice. So the seasonal changes, be aware of that, but also. Don't forget to focus on what happens whenever you're done helping somebody resolve an issue that they're coming to see you for it because that's really what's going to stabilize your practice long term.

And one other thing that I would want to kind of touch on here is this idea of the dip. So. Seth Godin wrote a book called the slopes short. If you're going to read it, you can. I'm going to kind of describe what you can learn from it. So I'll save you ten bucks in about two hours. But, the dip is all about this idea of anything that you start that's challenging.

There's this sort of new curve that develops. So imagine the kind of like. If you're looking at a, at a curve on a chart, like there's a bit of a spike whenever you're the first start out off, as you in that bottom left corner, if you're looking at it, it's this little spike, right? It's, it's the excitement spike.

It spikes. You get all excited, oh, I'm starting this business going to be amazing. You know, I'm going to help a ton of people. I'm going to make good money. It's going to be, and it's going to be awesome. So boom, I'm excited. We're, we're on the rise now. After a period of, I mean, a short period when you realize like, Oh my God, there's a lot of stuff to do.

There's a lot of things that I need to work on. There's, there's a lot of ways this could go right? And there's a lot of ways this can go wrong. And then the real work sets in that spike dips back down, and you end up in this, this sort of Valley, or this trough. And in this chart, and what that is, it was what he calls the dip.

And the dip is this place where the discomfort sets in the challenges set in the reality of what you've gotten yourself into sets in. And I can tell you that starting a business is not for everyone. And this is the place where people figure out if that's actually what they want to do or if it's not what they want to do.

And this is where most people that are going to give up and are going to go back to. And an employee position will do it. And you know, it's, it can be beneficial. It was useful for me to understand that everybody goes through the dip, and it's a shame when people give up in the middle of the slope.

They give up during this period of discomfort during this challenging phase. Because what they miss out on is an exponential increase. Once you get out of the Dick, so dip. So, this hockey stick changes where you just rise and rise, and you have this exponential change in a positive direction once you get out of the dip.

And this can be said really for. Anything, I mean, it could be said for athletics, could be said for school. Anything challenging that you're trying to do or accomplish, this still happens. You get excited at the beginning, and then the real work begins. And then there's this, you know, exponential positive change that occurs on the backend.

This happened with somebody recently that we worked with that rode across the Atlantic ocean in a single man boat. He was out there for like two months by himself. You know, and he was super excited as he signed up for it. He's getting his boat, all this stuff. We have a few months to train with him.

That's when the real work begins, you know, and he's, he's training for training, for preparation for it. The race starts, he completes the race. He, and again, he went through, you know, a lot of discomfort and challenges during those two months whenever he's rowing across the ocean. And, and on the back end.

You know, he was able to accomplish them. And that very few people do as well as raise awareness for a nonprofit that he, you know, he, he was working with to raise awareness and fundraise for a great cause, you know, so exponential change in the backend. So if you're going through this in your own business, don't, don't think that you're alone.

Like you're not, this happens to everybody. There's not a single person that I know that. It was just an easy, you know, linear change. It's like I start here; my revenue goes up every single month. I never have a, and I never have a challenge, never have anything I have to deal with, and like it's just super easy.

I'm just cruising like, it's very, very rare. It's sporadic. And if that is the case, those people probably spent years and years and years developing they're a reputation locally. They are expanding their clinical skillset, growing, you know, the base for practice by working somewhere in the area as a clinician and having this right local word of mouth presence for them in particular.

And then they move on, out on their own. Then they do their own thing. And even still, they're still going to go through periods of. Challenges and struggles that are going to test whether they made the right decision or not. So as you look at this, if this sounds familiar, if this sounds like something you're going through or something you've gone through, you know, and those of you that have gone through it as I have, it's easy for us to take a step back and see this for what it is.

But when you're going through it, it's so hard to realize that the struggle. Is normal. The battle is part of it, you know, and, and talking to this, this, this person, you know, and he said, man, I'm frustrated. I've only had like three or four people show up at a workshop. The last couple of times that I've done it.

And I said, dude, of course, they don't know who you are. You know, like, I, I was the same way. I mean, I've done workshops where I've had one person, one person showing up at a seminar that blows, that sucks. I know, but you know what? I thought to myself, all right. If this guy has come into my workshop, and I think the only reason he came is that he felt terrible for me, lane, legitimately.

I think that's why he stayed, but I said, you know what? I got one person. I'm going to make this the best hour. The best decision this guy has ever made was to hang with me for an hour. I'm going to figure out whatever it is that he's got going on. I'm going to help him solve that in that hour. He's going to leave with a ton of excellent value for his time.

And that's what I did. And I've had two, three people at workshops. I do the same thing. You know, I want to teach those workshops, like there are 50 people there that I'm trying to, to deliver excellent value to. And you know what happened after I did that when I taught there again. There were two or three times as many people.

The next time when I taught there again, the same thing happened. More and more people came back because they sort of know who I was. I started to realize that what I was talking about and what I was showing people was helpful, was unique and was what was benefiting them, not necessarily me just asking for something in return.

So when we're first getting started, and we're putting ourselves out there, it can be so damn frustrating and so demoralizing when you show up to do a workshop, and one fucking guy is standing there that's only there because he doesn't want you to feel like a loser. That's precisely the situations that I'm talking about that you put yourself in.

Nobody wants to be there. Nobody wants to do that, but you have to realize you decided that this is the path that you wanted to take, and I'm telling you, if you see it through, it's going to be the best decision of your life, the best decision you've ever made. If you see it through, if you quit, it's going to be the biggest regret that you have.

To be the biggest regret that you ever have, and you cannot get that back if you decide to go back and, and, and take a position that you don't want to work in because you gave up during a period of discomfort. That's tough. That's something you have to deal with for the rest of your life. Regret is forever.

You know, that discomfort that I had teaching workshops early on when nobody was there, and that lasted a couple of hours. And I forgot about it until I brought it up right now. Right. You know, like, I don't remember that I had only a few people show up until I have this conversation with this guy and, and I remember those things.

Right. But it's sort of like childbirth. I said, my wife, says I, I haven't had babies. My wife's had two with no pain meds. She's a badass. And she doesn't remember them that well. Do you know? And I think that that's why we had a second is because if she remembered how. Uncomfortable. It was like iron, probably remember better than she does.

Like the labor that she went through with Jack, our son, our older, kid. It was crazy. I, it's the most like the brutal thing I've ever watched in person. And then we decided to have another kid, and I can't believe that she wanted to do it, you know? And, and she did. She went through it again, and you forget about those things because what did we get from that?

We get this—these people in our life. You know these little kids that are so, so special to us, and our business is no different. Our company is remarkably similar. It's basically like a kid, you know? It's, it's challenging, and it's frustrating, and it's so meaningful and rewarding at the same time. So as you're going through this, and not, not to ramble about this, but I just.

I think it's a, it's a common pain point for so many people in the profession, in any, any job that is, that are starting a business in the first three years. The first three years of starting a business are the hardest part. The hardest part. You're gaining momentum. People are finding out who you are.

You're building your culture, your business, finding out what. Offers work with offers that don't work. And it's where most people end up giving up if they're not going to see it through it and make it so, you know if you're listening to this right now and you are going through something similar. I understand you're not alone.

This is why, for instance, like our mastermind group is so helpful and so, so beneficial because somebody like this can reach out to me. I can talk to them, connect them with somebody that just recently went through something very similar. They can have a conversation, talk about things that are working, but more than anything like he's going to be, this person's going to be okay.

They're going to be okay. They're, they're not going to their businesses is going to fail. They're going to, and they're going to be successful. They're just going through a rough patch right now. But there's a lot of people go through a rough patch and give up. The ability to be connected with other entrepreneurs that are going through something similar, have gone through something similar and can share resources about what is working and just be able to help create, a very beneficial place from, from a mindset standpoint where.

Your confidence, you can gain it back. Gain confidence, plus excellent clinical skills are dangerous. That's where we get massive changes in our business. Dangerous on a perfect day. Dangerous in a Baker Mayfield way, like an ideal way. Right? So, you know, being Noah connects that person. Not just myself, but somebody that has recently gone through it as well.

That's so valuable because it's going to help them get through this period much faster without necessarily sitting there by themselves, wondering if you know they made the wrong decision or wondering if they're the only person going through this. So if you're going through this, you know, understand you're not the only person that there is.

A lot of people going through it right now, and there's a lot of people that have gone through it. You're not alone. It's not abnormal just for you. It's, it's just the reason why so many people don't go into business for themselves is because of periods of the business like this where it's scary, where there's unknown and where there's a lot of self-doubts and a man like that is a recipe for some.

Shitty things to happen to you. It's just to be in a terrible place. And I think the more you can hear that this normal, then hopefully the better you will feel and the more you will feel like it's just a part of the journey. You know, it's, it's part of your Odyssey. You decided to, and you chose to do this, you know, I decided to do this, not knowing what the hell I was getting into.

And you know, I know there are rough, rough patches, there's, and there's going to be more for us going forward. That's just the way it is. You just sort of getting more accustomed to it, but you know. If you look at what you're trying to do and you align your intentions, and it's aligned with your business. The reason why you started decided to start it in the first place, you have to see it through for the people that you want to work with, for yourself, for your family, for the future of what you want your life to look like.

You have to do it, so you don't have any other choice. So you have to get comfortable with the discomfort and understand that it's just part of it. The job part of being an entrepreneur. And it's okay because there's a lot of positives associated with that as well. That comes along with it. So this is something that you'll get through, you'll get past, and it's just going to take some time.

It's going to take some effort, and it's going to take you getting turned down probably by people, and people not showing up and stuff that you're, that you're doing, and persistence. And if you have that, you'll be successful. Your business will be successful, and you'll look back, and you'll, you'll think of yourself.

Like, man, I learned a lesson from that. And now you'll be more resilient. You, you know, for that, you know, going forward. And that's what's so cool about entrepreneurship. It's just this, and it's this journey in personal development. Every single year should look back and be like, man, I feel like I've grown so much as a person.

You know, I feel like I barely recognize the person that I was or the decisions that I was making or the way I've viewed things. And that's what so cool about this. Just accelerated personal development, in my opinion. This is the way I look at it. And I think that if you look at it that way, it makes these crappy things.

We go through so much, more comfortable to tolerate. So that's it. That's a that's my answer to what do you do when your business is flatlined in a cash-based practice and, you're, you know, you're trying to get local marketing to work and then. It's just not, you know, she's not working at that time. This is, this is my advice for that.

I already talked to this person on the phone, but I figured I'd do a podcast on it cause there's probably a lot of you that are going through this, as well. And, and if you have questions, as always, you know, you can always reach out to the Facebook group that we have. You see, you can always, you know, leave feedback in the form of an iTunes review as well.

We check. Those. We try to respond to everything that we get. If we miss something, sorry. You know, we try to catch everything as it comes through. And if, if you're looking to do something like this, you know, when you want some lessons learned from somebody like myself that's gone through it, I highly recommend you check out F insurance book.com and get a copy of, of a, a fuck insurance because I go through the phases of this and where people are at. It should give you some guidance and clarity on where you're at within.

Within your business where you're trying to go. And a, as always, guys, I appreciate your time. I hope you get some value from this and enjoy the rest of your day.

Do you want more cash, PT, biz help? If so, get a copy of my book. Fuck Insurance. It's your playbook—so successful performance, PT practice, and never having to deal with insurance again. You can get a free copy at 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.