E564 | Buying A Cash-Based Practice With Elliot Lance

Today, I catch up with one of our Mastermind members, Elliot Lance! He goes over how he got a great clinical rotation at a cash-based practice, how he started his cash-based practice, and ultimately how he ended up buying the largest cash-based practice in Charleston, SC. Enjoy!

• Developing long-term health and wellness relationships
• Maintaining a great company culture
• Buying a business with your girlfriend

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Podcast Transcript

Danny: [00:00:00] So I was having a conversation with one of our staff members about documentation, and he had come over from a in-network practice that he was working at, and he was talking about just how long it would take him to document and click through and the workflow and how, just, how time consuming it was and how much easier it's been with the software that we use, which is PT everywhere.

And I know for us, we're very aware of sort of time leaks within our staff and our own schedules. And it's just one of the worst things you can do is just waste time on things when you could be doing them more efficiently. One thing for us is we have to document. It's something we need to do and you need to do it as efficiently as you possibly can because that's where you're gonna save a lot of your time.

We were seeing our staff members save upwards of an hour a day as far as cleaning up his documentation, making it more efficient. What if you got an hour of your day back just from documentation? What if all of your staff did the same thing? Highly recommend you take a look at PT everywhere.

It's been a huge time saver for us and really has made a big difference in our efficiency of our practice. You can check 'em [email protected]. I think you're gonna really like what they have to offer. [00:01:00] So here's the question. How do physical therapists like us who don't wanna see 30 patients a day, who don't wanna work home health and have real student loans create a career and life for ourselves that we've always dreamed about?

This is the question, and this podcast is the answer. My name's Danny Matte and welcome to the PT Entrepreneur Podcast.

What's going on guys? Doc Danny here with the PT Entre Tour podcast, and today I'm chatting with Elliot Lance, who has done it all. I'm so excited to talk about starting a practice, buying a practice, growing a practice in, I think a great city, Charleston, South Carolina, which is one of my favorite cities in the country.

But this is gonna be an interesting one because not only has Elliott started practice, but he's actually, he and his girlfriend, Hannah Bri, bought Eve Gigi's practice made to move and have now taken that forward and are growing it to [00:02:00] what it is now. I'm very excited to catch up on that side of the business, but also to learn more about what kind of person is, are you like going from starting a practice, like going to buying a practice and then growing what I think is like dude, right on the verge of a seven figure practice with made to move.

It's just, it's, and there's so much more there, which is so interesting. It's just, I think it's just such a great opportunity for you guys. But anyway let's do this. We're gonna back it up. Elliot, thanks for your time. You look like you guys were in, a great spot in that location.

What was the name of the gym you said you guys were in? Yeah, it's

Elliot: it's called Ethos Athletic Club. Yeah, cool. In the heart of downtown

Danny: Charleston. Yeah. All right let's do this, man. How, first of all, how'd you get into pt? I want to get a better idea of how you got in the profession and then I wanna dive into the business side of stuff.

Elliot: Yeah, so I feel in terms of pt, everyone has that, oh, I was a sports player and then I got her and had some amazing pt, nurse me back to health, and then I wanted to, pay it forward or whatever. I didn't really have that. I didn't really have any sort of inclination what did I wanted to do [00:03:00] in really even through probably three fourths of my undergrad career I knew I wanted to help people move and move better.

Cause as a, as an athlete, that was such a big part of my life. But it wasn't like some dream calling or anything like that. I just knew I wanted to help people. I actually, I went into undergrad ironically, looking to be a teacher of all things. And I just knew I cared about people and I wanted to help.

I thought teaching might be a good route. I still, I kind of joke with Hannah sometimes eventually I'm gonna retire and go be a teacher. But that's just the mindset I started with. And then it just so happens that physical therapy happened to be the vehicle to allow me to do that, to allow me to help people.

And I shadowed a bunch of people. I shadowed a couple clinics actually down here in Charleston. Yeah, before I graduated from Walford. And then I really liked those PTs, like the individuals. And I was like, shoot, I can do this. Like this is movement, this is exercise, this is teaching.[00:04:00]

And so that's what I chose. And so

Danny: here we are. I feel like it's a hundred percent teaching. In fact, my mentor is Kelly Tourette, and for him it's com he said, it's always hard when people ask him what do you do? Because he has a lot of things. And his answer that he is that he's decided that he's just gonna give everybody, is that he's a teacher.

That's that's all he says. And he goes, most people actually don't ask you much after that, which is interesting. But but in your case, I think it's, the ability to teach effectively within the clinic and educate at scale, even if you're talking about, a group of people, maybe a workshop even for the practice Yeah.

Is just teaching, but you're just teaching, basic movement health wellness skills, which I think you're, most people actually know very little about.

Elliot: Totally. Yeah. And I think it's what, like that kind of core principle is what helped me feel confident or comfortable at least in the early days of having started my own practice, right?

Yeah. I was like, okay, all I have to do is just helpless one individual sitting in front of me. That's it. Just keeping it simplistic like [00:05:00] that didn't allowed me to not freak out. Yeah. I like that about the bigger picture thing.

Danny: Did you, so when, okay, you graduated from PT school and did you start your practice immediately or did you work somewhere as a, a staff clinician in a clinic or what'd you do?

Yeah

Elliot: I started right off the rip right when I graduated. My rotations during PT school, they were all in the Charleston area except for one. And the first the first three were, very much run of the mill orthopedic insurance practices. And I got. I guess two outta three years through PT school.

And I actually got to the point where I actually didn't like it at all. I hated it. I considered dropping out. Like it was almost like the, this sunk cost mentality of I'm two, two of the three years the way through. I've already paid a bunch of money. I just was super discouraged about like where the, I was at least super discouraged about the rotations that I went on.

So it was just really challenging. I actually had a fourth rotation set up in Cleveland, Ohio of all places. Oh. My dad [00:06:00] was from there. It was another orthopedic insurance clinic. And at the time I was like shit, man, like this is probably gonna be more of the theme. There's just gonna be more of a bill.

And so I was like, really discouraged and I listened to one of your podcasts. So shout out to you. Oh, cool. With Andrew Miller and Andrew. I had already actually heard of him because I was a big baseball player in college, and so I actually hadn't heard of Andrew. I'd heard of Cressie. So like Cressie was a big name in the baseball world.

And I was like, damn. I'm like this guy who Danny is interviewing, like he does physical therapy. He does it inside of an incredible baseball facility. I'm like, I wanna do that. And so not really having any idea about cash base, not really having any idea. I didn't really know what cash base was.

I had met Eve before and like he came and spoke to our class down here in Charleston. But I didn't really know anything. And I was just, dipping my toes into your podcast. And so then[00:07:00] I went to my professor who was in charge of our clinical rotations. I was like, Hey, I really want to go here.

I told him the situation and they said no. So I went behind their back and reached out to Andrew anyway, and I was like, Hey, like I really wanna do this. Is there any way to set it up? And he was like, yeah, no problem. So we did a little zoom call and that was great. So he was like, yeah, no problem.

And I was like, great. And I basically told Andrew, I was like, Hey, I need you to send this request like basically on my behalf. And then it like, coming from Andrew and they were actually, they were like, okay this seems like a, this seems like a, an okay place for you to shadow. And so then they let me.

And that's it's funny looking back on it now cause like now I have a great relationship with Andrew and that's kinda led me Just a lot of different ways. So it is just been a whirlwind. How long were you

Danny: there? That rotation? Yeah and tell me this, so how long were you there And as a student in a cash-based practice, how did that rotation go in comparison to other[00:08:00] rotations you had?

Elliot: It was night and day different. I was there. I, so that rotation started at the end of January and it went, it was supposed to go until May when we graduated. However, this was 2020. And we actually, so we started in January. I went up to Boston or Hudson and we got through probably like early March.

Yeah. And the cl the clinic had to shut down. Everyone was shutting down. Cresty shut down. And so then M U S C called us home. So I was only there for, Man, it was probably a little less than three months. Yeah. Which was wild. But just even that, even in that shorter, that shortened time period, like you could tell like the biggest difference to me, not even really knowing about that cash base, like how to charge people and selling or anything like that.

What was really different was like, these people, or like Andrew had 60 to 90 minutes with each person and that blew [00:09:00] me away. Like it was like the smallest thing and like now what I take for granted. But but just the fact that like all of my other rotations were like 30 minutes, maybe 45 for an eval.

I'm sure I am preaching to the choir, to this audience, but that is the real, that's the reality of it. And I just, I didn't feel like I could teach, I didn't feel like I could communicate my value or really help people to the best of my ability in that clinic environment. Yeah.

So being able to have 60 to 90 minutes with each individual was, it was a dream. And so then, like Andrew was nice enough the balance of letting a student kind of help, but also they're paying Andrew, they're paying me like for my time. They don't want a student, working with them.

Andrew was, was very nice and basically it all comes down to communication. Just like having an open conversation with the with the patient and Hey, do you mind if Elliot, or do you mind if this person just kinda works in with us? 99 times out of a hundred they're like, no problem.

And just, I mean that, I think that speaks [00:10:00] to the relationship that Andrew had already built with his patients or with, with their patients that I was just like this no brainer that they would be willing to let that happen. Yeah, so that was my experience. It was incredible.

Anyone looking to rotate? With anyone in the group. Like I, I think Andrew and New Strong would be a great

Danny: place to look. Yeah. Yeah. Sh first of all, Andrew's awesome. So he listens to all these, so we can't say anything bad about 'em anyway. But he's great and he has, and it's a super cool facility if you are.

Yeah. It, if you like baseball, like that is, yeah. It was one of the better places in the country, and it's, and that's also a good time to be there because it's off season. There's a lot of guys rolling through there that come through before spring training, things like that, so it's a really elite place for that sport in particular.

And I think you do a really good job. Overall, like in, in particular just the gym, like the culture of the gym is really great. What Andrew is, built within that is really interesting. And it also goes to show you that there's so many different models [00:11:00] in which you can run this because he runs a, an open model, it's a training room model inside the gym as if it's, a training room at a, division one or pro center versus, made to move is a closed model, right?

So you have, you actually have offices and you have maybe a common gym area, but it's not the same. But either way you can make it work so many other, different ways. And it's really more about the quality of the interactions you're having with people versus just the actual like setting so much which, and I think you can take that as a student even you can feel that and you can see that with the conversations people are willing to have with you.

It's so interesting when you really get to a level where you're working with somebody and. It's almost like you've turned into this. It's like they're, it's their health and wellness advocate and their therapist and their, physical therapists all rolled into one. And you develop these long-term health and wellness relationships that I think are just so powerful.

And yet really, people aren't finding them anywhere else, and I think very needed. Anyway, that's great that that you saw that. And then obviously you can't go work at a clinic after that, so No. You came back and as soon as you graduated, you found a spot and got going. Yeah,

Elliot: exactly.

[00:12:00] Yeah, I was pretty ruined after that. COVID was weird. COVID, so we graduated, Hannah and I graduated during Covid. We didn't have graduation, like they recalled us in March and we basically sat around till May. We had to fight tooth and nail to take our board exam. So it was just a really chaotic time.

Like we were studying January, February, March, and then it got shut down and our test got canceled. Like test centers weren't open anymore. And so like I'd had this test scheduled that was already setting for it for months at that point. And so like that was a nightmare.

And so if you remember, Georgia was the first state to open back up, right? And so it was like, I was supposed to take my test in late April and Georgia opened up, like started opening up like around that time. And so we we lived in Charleston and Georgia started opening up like in the early to mid May and we started looking for test centers in Georgia.

We eventually, like we were up at 3:00 AM every night, [00:13:00] like refreshing the test center thing. Cause there was only so many thoughts and it was like a lot, it was like a, basically a lottery system. Did you click on this test center at the right time? And so we eventually whittled it down to where if you went on like early, early in the morning or late night, like 12:00 AM to 5:00 AM you had a really good chance of getting one.

And so we found a test center in Augusta, Georgia. And so we drove

Danny: barely across the border, barely

Elliot: across. And we we took our test like in the early, probably the second week in May. Wow. And and then we graduated. We had already graduated, but it was just wild. That was wild. And yeah. So then I started my practice on May 12th, 2020.

I started literally days after. And I was, I basically went into it with a mentality of I don't know what I'm doing. I had read your book, I'd listened to your podcast, but really? You never really know. So I was like, I don't know what I'm doing. But I'm gonna do cash base, I'm gonna do it in Charleston.

And and so I basically just reached out to a bunch of [00:14:00] gym owners had a little bit of warm connections and eventually found one that was didn't have an office for me, but would let me set up just basically a treatment table in the corner of his gym. And so that's what I did. And I knew I, coming out of that move strong rotation, I knew I wanted to do cash base in Charleston.

And the good thing was there was actually, like before, before I even set it up, there was a cash base clinic in Charleston that was hiring. Which was super exciting. It was called Mates in Ocean. Yeah. And they were hiring, but they had one spot. They were trying to take on another PT after Nate.

And they ended up hiring Hannah, my girlfriend instead of me, which was great. So I had to go kick rocks and set up my own clinic. But at the time, maid's move just had their location In Daniel Island? Yeah, in Summerville, which is towards like the eastern part of Charleston, if you will.

And so then I was like, all right, I'm gonna do this thing I'm gonna set up as far west in Charleston [00:15:00] as I possibly can. And so I went all the way over to James Island, which was on the other end, probably about an hour from our Daniel Island clinic. Yeah. Talk to a bunch of gym owners on the one that would set me up in the corner of his gem.

And so like the open model of Andrew and Krey really helped a ton cuz I also didn't have an office starting out. I had a little bit of experience like still having those communications, still having that relationship, still building that with a patient even without four walls.

Danny: Okay, so you set up in James Island, and then when did you set up the office In the city of Charleston?

Elliot: Yeah. No, that's another whirlwind. Yeah, and if I'm not making sense, please slow me down, but I will. So the gym in James Island was called Exemplar Fitness. The, they had two owners and like throughout 2021 they had grown and the two owners could not decide on how to continue to grow.

So they actually went their separate ways in the early part of 2021. [00:16:00] And so they actually decided to. Dissolve the gym. And they actually literally wanted to pick up and move. And one of the owners wanted to establish a mega jam in downtown Charleston. And so exemplar, the first gym ceased to exist.

It was towards Zeke March or April of 2021, I believe. And then they moved to a big facility downtown and named the Ethos Athletic Club. That build out from probably like February to what ended up being November left me the PT inside of it homeless. Yeah. So at that time I had like a decent amount of patience on my schedule.

Like I had been in practice for a little less than a year, but decent amount of patients had to figure out a place to treat 'em. So I went to another gym. Close, like around James Island and basically was like, Hey, I want this to be temporary, but like I, [00:17:00] I need a place to treat my patients while ethos is being built.

They said, yes, no problem. And so I just made them a little bit of rent and they let me treat out of there until Ethos was open. And then, so that's how that started. So exemplar, my first gym turned into ethos. Like they are, they're the same gym community with the same owner.

They're just now in different locations. And so

Danny: did you bring up, this is it's not a abnormal or uncommon story to be honest with you. Yeah, I had I think sub there's a lot of benefits to a subleased office in regards to speed, cost, access to your target audience. But what you sacrificed with that is stability because you're building your business on somebody else's foundation, man.

And I can think of. Three or four occasions where we've had to go somewhere else. Nothing with our business went wrong. And it's just oh, somebody forgot to get the certificate of occupancy for their building and it got shut down for a couple weeks. Yep. That [00:18:00] happens. Or another, a developer buys the building and kicks everybody out.

Yep. That happens. Like it's, yep. It happens. And it's, it is something that I think it's a great place to start and I recommend where most people don't stay there forever because you're gonna run into a lot of these problems and unless you can find like a, just a really great business owner that owns a gym and there's a strong, like Cressie for instance, is like a great example of that's not going anywhere.

But a lot of times it's just people that aren't, you don't really know what their business chops are like, and and it, you can put you in a bad spot. For where you guys are now and fast forward, I guess a little bit in terms of you have your practice going, it's right.

You're doing well. Hannah's working for, made to move and and then there's this opportunity to potentially take over or I guess, yeah let's, let me get the store because I think it was potentially for Eve to buy you guys out and roll you into May to move. And then it turned into, you know what, I think maybe you have more bandwidth than [00:19:00] we, we do at this point, or than he did.

Yeah. And that turned into you buying it. So talk to me about that process a little bit, because you already had a business going, right? So it's not like you didn't know what was going on. You weren't new to it, but this, it's a new venture to take on a company that's a few times bigger than even your clinic was.

Yeah, absolutely. Yeah.

Elliot: Yeah. Walking through this timeline when Ethos was finally starting to open I had months at the temporary, the quote unquote temporary space that I was supposed to be at. And a couple of months there had shown okay, this gym could also that gym community also started coming to me.

It, it became very apparent that we, that I, that my business could hold two locations. And so that kinda escalated into the fall of 21. And in August of 2021, I hired, I went ahead and hired pr, like probably a little prematurely. Knowing that[00:20:00] I would need help the moment ETHOS opened.

And so hired, brought on my first pt. Her name is Rachel. Rachel, and I basically treated at our temporary location. And then when ETHOS opened, I gave her ethos and I took the other location and we grew that. And then in. All the while, like I obviously had this like inside source with Hannah who all this time had been working for Eve.

I made some move. She had become the head clinician on Daniel Island, which was their, big standalone. And so there, there came a, there, there was a dinner that Hannah and I had. Cause we'd been dating this whole time, like there was a dinner we had that we would talk about what we were doing and we were just like, dude, like what the hell are we doing?

Like, why are we not doing this together somehow, and so obviously like talks of like, how do I bring Hannah on into crime? Like that, those conversations happened and then Hannah was like let me just see where Eve is at with this idea. [00:21:00] Hannah talked to Eve and they spoke about it and obviously it was something that Eve had been thinking about too.

And, they, with ethos opening and that was gonna be a big a big catalyst for growth for us. Just having a big location downtown. At we both knew that Eve I, Hannah, like we all knew it. And he started considering okay I think Made to move, wants to move into downtown.

Like why don't we just, why don't we just acquire Elliot? And so that's where the conversation started. We talked about it for a couple weeks and then, there was this one Sunday I'll never forget it. Eve called both Hannah and I and was like, Hey, meet me at the clinic.

I just wanna talk, I just wanna run some things by you. And Hannah and I were like, shit, he's gonna back out. This isn't happening anymore. He like that was our thought. Like something like, it was just such a weird thing to say. Yeah. And so we we, like begrudgingly went to the clinic and we were expecting the worst.

And cause we were starting to get to the point where we needed to have like my business, like value put a value on it and we were gonna sell. And he came up to [00:22:00] us and he was like, so I've done a lot of thinking like, PT biz and his role there was increasing.

And he felt like he didn't have the bandwidth to do all of the things that he wanted to do or to make the impact that he wanted to make. And, obviously he has kids too and he wants to travel and, he just, he wants to make sure that he's setting himself up for the life that he wants to live.

And so he came up to us and he was like, how would y'all feel about buying me out? We were shit that's crazy. And so we talked about it. And then we we knew that it was a, it was an offer we couldn't refuse just cuz we knew with with Hannah's like her growth fun island.

And with Ethan's coming up and with the now like confidence that we had we knew that we could grow it into something really special. Especially with Hannah and I worked together like the bandwidth of two very eager clinicians and business owners the bandwidth of Hannah and I, we knew that put our head down and busted our ass.

We could take this somewhere really

Danny: big. Yeah. Yeah. It's, I mean it's really interesting [00:23:00] to hear it. From your perspective, just cuz I like, we talk Yeah. Almost every day, Eve and I. Yeah. And and we're very familiar with each other's businesses and and yeah, I think, what's interesting is to sometimes people try to sell businesses because there's something wrong with them and, when you look at Made to Move, the only thing wrong with it was that what we were doing with PT Biz was just growing so fast and it was requiring so much time that you, we could, we, you couldn't put the same amount of focus that, or the focus that was needed on that business, like just couldn't be there.

So to be able to look at it and be like, There's nothing wrong with this. This is actually, in fact, this says great brand recognition and a really strong, track record and lots of preexisting clients, and just like all the infrastructure you would look for it's like the dream scenario to be able to find a business like that, that you [00:24:00] also want to run and you have the desire to, to really, make into what I think if I'm speaking for Eve I think for him he would think I hope this turns into what I want it to, would want it to look like myself over the next few years.

But it just doesn't have the bandwidth to do. But even on his side, for to be, for him to be able to say man, I just can't do all of it. That's really hard to do because that's like another kid. He basically sold you his third kid, so it's tough. Yeah. And he's, it's just, it's a challenging thing.

I think for you guys, it's really interesting to see what a good fit. It has been. And also just to see what you guys have already been able to do with the business, while also like making it your own, but also like maintaining, the core values of Made to Move and, how we f you know, I'm sure you feel the same way about how people should be treated and and worked with and I think that's always the fear with these businesses that'll, you'll sell it to a big ortho group or something like that, and they ruin it, and it's ugh.

Like not, it's not worth it. It's not worth the additional money that it might be there. So what has been the most [00:25:00] challenging part of you had your own business, but like acquiring a business and then, going that side what's been the hardest part about the actual acquisition and implementation side of the new business?

Elliot: Yeah. No, man there's a lot there. I think, so first of all I. By the time that Eve had considered selling, like he was like, he was rarely treating, cause he was basically just the business owner. And not only that, he had just a lot of responsibility that PT Bim and his other company EF Ft.

Like he just had a lot on his plate, arguably too much. And so then like no matter how hard he worked, like that was just a it was a really tough situation to be successful in. My, my favorite expression of physical therapy, but it applies to everything, is if you chased two rabbits, you're probably not kissing either, right?

And like that was the perfect example of him chasing a bunch of rabbits and they're all well intentioned and that's great. But I'd say the hardest [00:26:00] part of it was like bringing on the current made to move staff. So at the time we had Dan, who essentially ran that business. Who was like absolutely essential.

Dane knew everything and anything about, how made move operated. And with Eve, selling it gave him an opportunity to focus on what he wanted to be passionate about. And that was his that was eft That was right. That's our online training program. So like it gave him an opportunity to, to exit, which was, great.

And we're obviously very close to Dane still and but like realizing how essential, cuz Hannah was an incredible clinician. But Dan ran the business and so there's just a lot behind the scenes that like, that was going to be very we were gonna have to learn very quickly cuz like you said, like it was a business that was, pretty considerably bigger than mine at the time.

I was just learn like I had, I was two months into having my first employee and now I have seven. So it's just a lot to learn really quickly. That was. [00:27:00] Probably the toughest one. And having to learn all of that very quickly without danger was extremely challenging. The clinicians that we brought on weren't, they weren't trained by us.

The, we had to train a new front desk person. Cause Dan had left. Like we had to train a new front desk person within the first month of having this business. It was just the hustle of that, those first two to three months was exhausting.

Danny: Yeah, I bet. And I think that's part of the challenge when you're looking at any ac acquisition of anything.

It's not yours. You don't have that depth of understanding. Dane is. Was the Swiss Army knife of that place who did to fill people in the gap? So he's, he was essentially the office manager, the operator of the he did everything of the facility. Yeah. And super squared away, just in general.

He's just a really really great operator. So that's a tough person to replace as well, and I think that's the culture is the challenge too, because when you take [00:28:00] over a business where you've not been the face of that at all, you have to then establish what that, the cadence of leadership looks like, what the core values, are gonna be, if they're gonna change somewhat what, feel you want to have of the actual culture.

So for you, aside from like the operations difference and you're right, you go from basically yourself, plus you just added somebody. Like to an actual business where there's like actual operating procedures and there's a lot of stuff happening without you necessarily directly having hand Yeah. A handbook.

It's very hard. It's very, it's it is just very different because it's, it, it's, it, there's just so many more people that you can't there's usually a stage you go through where you bring somebody on and you have to learn a lot of hard lessons when it comes to, oh yeah, I, you do need to request, like, when you want to take vacation because we have to close your schedule.

Or like simple simple things. You're like, oh yeah, that makes sense. Versus it's already in place. It's just maybe not the system you're used to running. So under saying how to do all this stuff [00:29:00] is tough, but what would you say the difference is that you've made or that you and Hannah have initiated as far as culture goes?

Is there a slightly different feel and if so, like what's a different feel in the business?

Elliot: Yeah. Yeah. And like that that whole, process that you're describing, like I always want to give 1000000% credit to Hannah for this. Like the I, like at least I got to start my entrepreneurial journey, like very slow and like a methodical, I meant it spiked, but like Hannah had, no, Hannah had nothing.

Hannah had zero, literally to a hundred. So the and she was the one that was that already had rapport with a lot of the current mates move people. And so like her being able to think on her feet and be really adaptable and take on that role that she had been colleagues with, and then now she was becoming their boss.

Yeah, I can't imagine how difficult that was for her. And so she deserves it, all the credit in the world in terms of culture.[00:30:00] Like Eve is a such a great person. But so the core values or like the, like the, almost like the business ethics side of things was like, was super easy.

We were just nice people who wanna make a difference, right? So that, that really wasn't that, that difficult. The, I think where the culture shifts like, or shift is probably even too strong of a word, but the culture tweaked if you will really just came into like how we wanted to communicate during our sessions, during our evals with patients, right?

And Eve is like had built, made move into something that was like a the place to go if you had a. Injury. And you were interested in a lifelong like a lifelong athlete which is awesome, right? And I would say 99% of strive to be. So like we're already standing on such a great like baseline, but what we tried [00:31:00] to add on top of it is like we, we have tried to over the last year, like tried to emphasize how much our communication matters when talking with people.

Man, there's so many studies that are out there now talking about like how patients just just their perception on their healthcare journey, their perception on pain, their perception on what they think, what they know, what they believe about their pain and their injury and all of these things.

Like all of those factors plays such a huge role. And so we like to think of it as taking what. What was an awesome baseline for musculoskeletal injury and just adding on this layer of like, how can we be really effective communicators with our clients, with our patients so that we know that we are we are always using our language and our words to empower, to boost as opposed to like to detract and harm and like offering.

I think a lot of clinicians either knowingly or unknowingly can do a lot of harm on how the patient, perceives their injury and [00:32:00] pain. Call it like, call it noce, , call it whatever you want. But we've tried to shift our culture into being really effective communicators.

Danny: I think it's huge. It's, it's funny how that seems obvious, right? It just seems, it's no shit. But yeah. Think about how many times you have to talk to a patient that it's so hard to un unhear bad information that they've gotten, right? It's just I can't say how many times I've had patients that are like, yeah, doc says I have the back of an 85 year old man who knew.

It's I guess I just, I'm screwed. And what, why would someone say that to you? And it's just a way people communicate a as well as it's like little things I think that we say, or that you hear someone in a position of authority and of far more knowledge in a specific area than you, that they may say something that is just like completely, they don't even mean it that way, right?

They're just busy, right? And they're quickly moving onto something else and. [00:33:00] But you hear every word, right? Because it's your body. So I think that's huge. How do you guys, how do you guys, do you what's your way of making sure that is consistent? Yeah. Cool. Great

Elliot: question. So we, I think one of the best things that we have implemented since we've started is every Wednesday we have a staff meeting every Wednesday Wednesday evening.

And so that usually was, or I guess previously that had just been for going over numbers and like how do, how can we get out in the community more like all the things that Eve loves, right? So that Eve loves getting out in the community and Eve loves metrics or not metrics, but like operations, right?

And so that was what that meeting was for and that's awesome. A lot of clinics will do really well with that. But with this shift, like we wanted to. Really prioritize like the patient experience and the patient communication. So we started what we've termed like clinical and nonclinical growth meetings for our staff.

And so every Wednesday we either have a clinical growth meeting, which is two of our clinicians presenting on [00:34:00] either a paper or a podcast or a research article or a blog. And so they take usually an hour to present that to the team, and then we have a discussion about it. And I think that doing that every single Wednesday has led to our team feeling really confident in their ability to provide an amazing service which is awesome.

And in the nonclinical growth meetings, we do that once a month. So three outta the four Wednesdays. So for clinical, one of the Wednesdays is for nonclinical. And what we do there, we talk about all the things that make up our job that's. That aren't deemed quote unquote clinical. So like that might be communication, that might be handling objections, that might be like we did one on StoryBrand and just like how to tell a story, which again comes down to communication, but like how to one was like on how to give like an effective analogy.

Like all of these like little things that we do all the time with our patients, but no one's ever really trained us on 'em. And we had one on, we had one on like how to sell[00:35:00] which I think in this model is so important. Yeah. So like providing an opportunity where once a month we can talk about either a topic of either my choice or Hannah's choice or the team's choice to start to develop just start to develop our skillset in other ways.

Danny: Yeah, I think that's huge, man. It's interesting when you start looking at just ways to run a business, there's so many different ways you can do it effectively. And I think it just comes down to the biggest thing is being consistent, whatever it is, following the right tempo, doing the right, doing it over and over again.

And for your team to know what they're like, what's, what is what's winning, right? What game are you playing? What are the rules and how do you be successful? Which I think for a lot of people is tough. Have you found it difficult to lead and, you and or Hannah found it difficult to lead people that are essentially all the same age, because aren't almost all you guys basically like a similar age in the profession, right?

Yeah.

Elliot: Not [00:36:00] overly cause I wouldn't, I would say And I don't really we're not really that imposing. We're pretty we try to run a a business that is very just a lot of equals moving in the same direction. So there's not a huge power dynamic. I don't know I don't think there's been a huge a huge struggle in terms of leading them.

I think everything we bring to the group we bring as a question. So just being curious hey we had some thoughts on how to how to improve our our communication during the eval. And so we'll just like basically pose it as a, an opportunity to brainstorm as opposed to Hey, I'm Elliot and this is what we should do, or, I'm Hannah and this is what we should do.

And so just like creating mats culture just like curiosity and asking questions and we're just all like-minded people moving in the same direction. I think, in my opinion, has negated a lot of that potential strike.

Danny: Yeah. Which I [00:37:00] think anytime you, there's a regime change, maybe not the best word, but just like a change of leadership.

Yeah. It's tough. I would see this in the Army a lot because. Leaders get moved all the time. It's rare that you're anywhere more than probably max three years. And everybody else is transitioning at different times as well. So you may have a group of people together for a year, and every time that there's a new boss that comes in, it's always interesting to see what happened.

Some people are super down for it. They're like, yeah, I wanna make all these changes. And then there's some people that are, they've been through five bosses and they're like, I'm not changing shit. I'm just gonna wait 'em out till they get tired. And it's just figuring out the right way to go about that, I think that for you guys, it's been interesting to watch and just hear how the business is doing. Because ultimately, I think as long as you're trending the direction that you want to go and your people feel like you're, competent and, but you really care about them, that they're willing to, be a part of your vision as long as you're willing to articulate, what that is.

Yeah. And I'm interested for you, what do [00:38:00] you see made to move, turning into over the next three years? What would be a home run for you guys?

Elliot: Yeah. First of all, I think you hit the nail in the head. If your team just like really and truly believes that you give a shit about them, that you genuinely care yeah, man, I think that's the key made to move.

Yeah, three it's changed a little bit, but if you had asked me a year ago the goal was franchising. The goal would be to move beyond Charleston. And so I think we I think we called it like our little, like tribes. So like we were thinking like, okay, we're gonna have a Charleston tribe, right?

Which the tribe could consist of three to five clinics, right? And then maybe we go to, Charlotte, maybe we come join you down Atlanta or Savannah or something like that. I think that was kinda where we thought things were gonna go. And so the, as the years gone on, my mindset shifted a little bit.

I think we've really noticed how we are. Like I think we talk all the time. I think I heard this from you originally. But[00:39:00] like how. Little of the, like a hello footprint, cash based practices. You really, truly have the insurance world. There's just, there's so many clinics and there's so many people out there.

Like it's just like we are in, we are a small fish in a huge healthcare pond. And over the last year, I've really started to feel like we are starting to shift that narrative even a little bit in Charleston. So I think we've turned from wanting to franchise in other locations to be like, how do we take the majority of Charleston?

How do, if someone gets injured or someone goes to an ortho, like how do we become the. Okay, you are hurt. You should go see me to move. And like, how is, how do we get to the point where everyone has that statement go to me to move. They're the people who will give you the time, will give you the care that you deserve.

I think as we've grown [00:40:00] in Charleston, that I think we've started to see that. Like we started to see like how we can, there's a potential to break through there. We're starting to get more orthopedic referrals than we ever have. We're like, they're, because we have five locations now here in Charleston, like there's not a gym that doesn't hear about us.

We have eight clinicians going to do weekly drop-ins everywhere. Like it's starting. So I think the shift is now similar to my favorite quote, chase two rabbits, you probably won't catch either. What happens if we just focus on Charleston and become the only place to go in Charleston unquote?

Danny: Dude, I'll tell you what, it'd be way easier. I wouldn't say easier. I always look at things. Now I try to look at things in probabilities, right? So if, I'm sure if I say to myself, all right, it's very few things are a hundred percent probable the, this is gonna happen. But lots of stuff is 50 50. But I feel good if it's 70%, if it's okay, I'm 70% certain that this is the right thing [00:41:00] and there's some beard and uncertainty around whether that's the right decision or not.

But if I'm 70%, I go for it. And when I, we've looked at many business models and I think I. Having friends that own franchises, and they're the friend that they actually started it. And there's some interesting problems with those businesses. There's also great reward that can come from that.

But I can tell you for me, the thing that I miss the most about being in, in a clinical environment day to day is frankly the people. It's like the. A little tribe you create, and it's hard to do that. And if it's, it becomes more fragmented, the more you are removed from the center of of that, I think as I hear what you guys are talking about, I think the probability is probably far higher that, you can dominate a market. And I think if you do dominate a market, you always have the option to do other things, but Totally, until you do, I don't know how probable, you would be to say, I can do this in another area [00:42:00] where I don't have all these deep connections.

And I read a book, it's called Small Giants, and it's a book that I really liked a lot. It's all about businesses that have intentionally just decided to be the best at something and not necessarily be the biggest. And I always thought that, and not necessarily, they're not big, they're pretty big companies.

But I always found that idea really fascinating. And I think with With the type of practices that we're talking about. It's like you have such a cool opportunity to change a lot of people's lives, and there's a lot of people that live in Charleston and continue to move there. It's getting bigger every day, right?

There's a lot of folks. And that goes to then you have, there's so many other options, right? So you have okay, we do more of these satellite offices. We can have a big training center and then like a hub and spoke with like smaller offices all around it. And there's just a lot that you can do.

So anyway, I love to hear where people are going with things and how it evolves too. Yeah. That doesn't even, that doesn't even throw into the mix. You start to a you get married, have kids, and then like time gets sucked up and then see what your vision is. Cause it might be like, you know what, maybe not.[00:43:00]

Maybe this isn't the most important. Exactly.

Elliot: Speaking of that, I actually have a quick question

Danny: about that topic before I let you finish. How has it been buying a business with your girlfriend? I feel like dad is like a. It's not, some people get dogs together or something,

Elliot: like that.

We did that too. Cosig. So

Danny: you have a dog, have two dogs. I

Elliot: did a business, two dogs. Alright. So what's that

Danny: process like? Is it, I don't know, was it man, did you even put any additional thought into it? I don't know, maybe this is the best idea or maybe this

Elliot: is an awesome idea.

Yeah, no I definitely we definitely had to think about it. It was interesting cause what really happened was, like I just brought on Hannah as a 50% owner of Prime, which is my business. And so then Prime bought, made more is technically what's happened. And so bringing ha like bringing Hannah on, if I could, speaking like candidly or like selfishly okay, I'm like, I'm basically giving Hannah 50% of what I've worked for up until this point.

And so like that initial thought, like when you have that [00:44:00] first thought that comes into your head oh, is this the right, is this the right decision? It was like I remember it happening like the, it was the quickest shift or like the quickest transformation in my head of two things.

Like one there's no one I would even imagine. There's no one I'd rather go on this journey with than her. She is probably the hardest working and just like the person who cares about her patients, her employees, like the I can't speak highly enough of her and how hard she works to be the best at the best clinician so that she can provide the best care.

And so as a distance owner, like. You can ask for anything more. And not only that, like she's just she was a fast learner. Like she was able to pick up so many different things that that would've taken me months or maybe even years to learn. Once again, like that that first thought, that first fear, that first [00:45:00] hesitancy like that naturally comes to the forefront of your head, but like it quickly got diminished with just knowing her personality.

And so anyone who's looking to go into business with something else like it, I really think it, it doesn't matter what they provide, what value that they have, like it, it comes down to what kind of person they are. And it's, it will always be a nerve-wracking decision, but if you have the, if you have the right person that you're going into business with, like it, it will end up being a no-brainer.

And It almost didn't even matter that we were dating at the time. It just us dating allowed me to know her, on a level that that I wouldn't ever know a business partner. So it just, it almost gave me a headstart in knowing the personality of my future business partner or my business partner.

Which again, is everything, which is the only thing that I think matters when going into something like that.

Danny: Hundred percent. It was nerve. I think it's also there's opposing skillsets from my understanding with you [00:46:00] guys too, like strength and weaknesses. I think as you look at this business partnerships in general, the ones that I've seen that end up not working out, they're people, they're exactly the same.

It's like buddies that decided they wanted to do something together but they're essentially the same. And the reason that they're buddies is because they're similar, and that's right. That's, that is. That's just the way that a lot of business partnerships are started versus, it's funny when I, when we see a lot of it is spouses, right?

Like spouses working together, and usually from my experience, they tend to not be that similar. They actually tend to have, it's not that they're not similar, they just have, they have differences in terms of what they're good at. One is a great integrator, one is really good on the sales and marketing side, and more maybe the visual sort of like dragging people into their future vision.

But the other person is we're organizing shit because you suck at scheduling stuff. And like that combo is actually really powerful. So [00:47:00] yeah, whether you're dating or not, like that, that offsetting of skills is I think the key.

Elliot: Yeah, I think there's, I think there's a lot to unpack there.

But yeah the offsetting of skills and As long as you really know and trust the person and your offsetting skills are still going in the same direction. It seems like a slam dunk, which I definitely have that

Danny: with him. I think it's compounding more than anything. Like from what I've seen, like I have two amazing business partners and I've had a business with my spouse, both, both of which are there's just no way I would be able to do what we have done and what we're doing now.

Totally. If I was doing something all by myself and just hiring people, like I just don't see, you don't have the same level of. Being bought in as somebody in a key position that is a true partner in that business. It just and I used to think it was like, the last thing you should do is [00:48:00] have a business partner, and I've gotten that advice from people I really respect.

They're like, never anybody besides your spouse. It's just man, it's because I think for a lot of people, they can't, it's very hard for them to find the right fits. And then there's so many bad exam or examples of bad business partnerships.

Elliot: I couldn't agree more. You said it really well. Yeah.

Danny: Let's do this, let's finish up.

Where can people find out more if they're, if they want to, if they're a student and they want to come to your clinic and now you're stuck. He's talked about how helpful it was. You gotta take on all these students. Where do they go to find out more, eventually work for you? One day,

Elliot: I joke with Hannah, we get like one email a week.

It seems like I students one in shadow and everything. And so I made a promise very early that I will take all of them. Just because I knew how much it meant timetable might be like, our time, our timelines might not meet up, but I'm going to, I will, Elliot personally will reach back out to you.

So if you are a student reached out to, you can shoot us at an Instagram DM or something like that. I'm [00:49:00] sure I'm gonna get 50 after the podcast airs. But but yeah, so reach out through Instagram or you can email us at front desk, made new pt.com. That's probably the easiest way to do that.

Otherwise like just to learn more about us and we're up to we're pretty big on Instagram. That's Hannah's thing and she's great at it follow us on me pt. That's the number too. That would be great. Other ways I think. I definitely think should follow we, we really know and respect the movement who are doing an incredible job out there in Canada as well.

Yeah. Of all the clinicians or all the clinics that are that we try to model ourselves after, like out of everyone in the group, it's prob it's probably them. So I'm gonna give them a shout out too. Just like anyone who's learning or interested in what we do obviously follow us, but I think they're a work rock call as well.

Dude,

Danny: they're awesome. Those guys are so great. And they're doing really They're building a really cool culture in the Toronto area, which is awesome to see in, in, in a nation [00:50:00] that is socialized medicine, which is even, more impressive for what they've accomplished.

Anyway, Elliot, I know you're a busy guy, man. We'll wrap it up here.

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