E840 | The Mindset Needed To Invest In Your Own Clinic

Struggling to grow because you’re debt-averse? You’re not alone.

In this episode, Doc Danny shares why debt is one of the most common mindset barriers that holds physical therapy clinic owners back from scaling. Drawing from his own experience bootstrapping his clinic and helping over 1,000 clinicians grow theirs, he breaks down why your money mindset—not your business model—might be slowing you down.

Why Debt Aversion Makes Sense—But Still Holds You Back
Most clinicians leave school with $150K–$300K in student loans and start earning $75K–$85K. That creates a natural fear of taking on more debt, even if it’s for a business. But Doc Danny explains how this fear can block your path to financial and time freedom—unless you shift your mindset from “clinician with a business” to “business owner who happens to be a clinician.”

Lifestyle Business vs. Scalable Clinic
Starting a cash-based PT clinic with low overhead is often low-risk and bootstrap-friendly. But when it's time to hire staff, build a team, and expand your space, that same debt-avoidant mindset becomes your bottleneck. The key is knowing when to keep it small—and when to invest in growing big.

Bootstrapping vs. Borrowing: The Real Risk
Danny shares his personal story of funding a clinic expansion with 100% savings—and how it created more stress than any other time in his career. His lesson? Bootstrapping might feel safer, but strategic debt can actually lower stress, protect your cash reserves, and accelerate growth.

Why Borrowing Is an Investment—Not a Gamble
If you use debt to increase your clinic’s revenue, support your staff, and create capacity, it’s not a risk—it’s an investment. Doc Danny urges clinic owners to think like investors: borrow in a position of strength, not desperation, and build a system that pays back the debt through business growth.

Get Through the “Profit Dip” Faster
As you grow beyond yourself, profit margins take a temporary dip. This is normal. Danny explains how to push through this phase—where you feel like you're working harder but earning less—and come out stronger, with a real business that supports your vision, your family, and your team.

Helpful Resources to Get You Started:

• PT Biz Website – Get expert coaching to start and scale your clinic

• Join the 5-Day Challenge – Build your practice with clarity and momentum

• Get the PT Biz Book – Learn how 240+ clinicians grew their dream practice (many with smart debt)

• PT Biz YouTube Channel – Weekly insights on business growth and strategy

Key Takeaway
If you want time freedom, financial growth, and a business that runs without you… you're going to have to get comfortable with debt. Not reckless credit card debt—but strategic, business-focused investment that accelerates your clinic’s success.

Want help navigating these phases?
Visit physicaltherapybiz.com or book a free strategy call to talk through your goals with someone who’s helped over 1,000 practices do the same.

Do you enjoy the podcast?  If so, leave us a 5-star review on iTunes and tell a friend to do the same!

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] Hey, Danny Matta here, founder of PT Biz, and today we're gonna talk about one of the biggest killers of momentum that I see in clinics and it has to do with debt.

One thing that I've realized over the last 11 years since I started my my clinic and having worked with about a thousand clinicians, both starting and scaling their clinics, is that. Clinicians are incredibly debt averse and it's for good reason. Let's. Talk about that for a second. The A PTA states that the average clinician comes out of school with around $150,000 in student loans.

Uh, this is a significant amount of money. I've met clinicians who have as high as $300,000 in student debt coming out of, uh, of school, um, both combined undergrad and grad school, which is a enormous amount of money and incredibly stressful when you're trying to manage. [00:01:00] Obviously paying for that and coming outta school and starting by making, you know, 75 to maybe $85,000, um, as a staff clinician.

So if you think I have 150,000 to $300,000 in debt. And you're making 75, 80 $5,000 a year. There's a, there's a pretty big discrepancy between the money it took for you to be able to get into the career and what you're actually making. Right? And, and this is a, it's very lopsided. Um, so what happens, well, a lot of people look at, uh, starting a clinic as a way for them to make more money, uh, in order to be able to, uh.

Number one, pay their loans off, but also to, to live the life that they want. We have seen many people go this direction, right? This is something that is a trend that is occurring and has been occurring in our profession for a long time. I've been talking about this now, you know, this is podcast number 800 and something I, I don't even know of lost count.

Uh, but I've been talking about this for years and it's, it's [00:02:00] not stopping anytime soon. It's continuing to go that direction. It's continuing to snowball that direction and when. Clinicians go and start their own clinic. In most cases, the vast majority of cases you can bootstrap. And start that clinic for, for very little money, a as low as a couple thousand dollars.

Right? Um, it's not a massive amount of loans you have to take out in order to start a clinic, especially if it's a cash-based clinic and you do it in a small footprint. And this is in many ways the beauty of being able to start one of these businesses. But I like to think of a. Uh, you know, sublease space, a very low overhead, cash-based clinic, in particular as like a business with training wheels.

It's. A great way to dip your toe in the water of entrepreneurship. You're not gonna financially ruin yourself if you're wrong. You know, you're not taking out a few hundred thousand dollars in loans and taking a big swing on, you know, whatever type of business that, uh, you know, that you're trying to start.

And, and we [00:03:00] see businesses fail all the time. There's a ice cream shop down the road from, from us, and it went out of business within a couple months. And it was just like they did like everything wrong. It was a bad business plan wherever they initiated. And they went outta business and they put a bunch of money into this space.

Uh, and who knows what kind of debt they racked up doing that. But businesses aren't a guarantee that they're going to work. Even businesses like this that we know people have. Back pain and neck pain and they don't know what to do. And if you're good at your job, we definitely have a proven track record of people paying you to help them with that problem.

And being able to establish at a minimum, at a minimum, a lifestyle business for yourself. And that means, in most cases, making twice what you could possibly, you know, make as a staff clinician somewhere else. Um, if you run it effectively. Right. That's a whole nother story of like, how do you actually, you know, run a business?

This is skills you don't learn in school. Obviously. This is why we've put out so much information as we have. But when we look at the nuts and bolts of the actual [00:04:00] business, the start is very low risk. Incredibly low risk. And what's great about that is it allows you to do a couple things. Number one, you get a chance to, uh, see if you even like running a business.

Some people think they want to be a business owner until they actually start a business and they realize that it is quite stressful. There's a lot of things that are not guaranteed, um, and they don't handle it very well. They don't have the personality for that. They don't enjoy, uh, getting out. And trying to drum up business, they're very sensitive to getting turned down by people, uh, which is gonna happen for sure.

Like, don't get me wrong, they, they're sitting in an office by themself and they're, they're worried about all these things that are may or may not happen, um, as they're trying to grow their clinic schedule versus like really getting out there and making it happen. So what a great way to test something out that maybe you don't wanna do anyway.

And you realize, yeah, I prefer to work in the profession and I'm, I'm gonna figure out what option works best for me to do that. What a great way to do that without having to, you know, take a huge [00:05:00] swing and take out a bunch of debt. Uh, the other thing is, it is a, is a very simple way of getting into business ownership.

There's not a lot of complexity financially, especially if it's a cash based clinic. Um, you know, it's something that is. It's, it's doable for most people in the profession to, at a minimum get to a place where they replace their income. Um, and they don't have to be business geniuses or spend a ton of time like learning the intricacies of business.

In order to get to that point, they need basic information. They need to change their mindset about what they can actually do. They need to learn sales and marketing primarily. Um, you know, and how to put those things together in a way that makes sense for your population. Right. Um. But when you go to then step into what I consider a real business and you go from, okay, it's just gonna be me to now, I want to grow a space, I want to build a space that I can employ multiple [00:06:00] clinicians, whatever other services you wanna lump into that, whatever your vision is, but you're taking a big step towards that.

Now all of a sudden you have to change your mindset, your mindset. Of this small sublease space that you have where maybe it's just, uh, you want to keep it as a lifestyle business, which there's nothing wrong with that, by the way, if that's what you wanna do and that fits your life, that's why we call it a lifestyle business.

You could just stay there and great. Just be content with that if that's what you want. For a lot of people, they want to grow past themself. They wanna have a bigger impact, and they wanna play the entrepreneurial game on a different level. You know, think of it like a video game, like you're on like level one in, uh, you know, a, a lifestyle business and you wanna see if you can get to like level 10.

Uh, and that means you have to do these other things within, within the business to grow past yourself and to grow a bigger business from a revenue standpoint, a team standpoint and impact standpoint. Lots of things. And in order to do that. Here's a big shift that needs to happen that I see a lot of people struggle with, [00:07:00] and that is going from the idea of being a, a clinic owner.

You're, you're a clinician who owns a business to being a business owner who happens to be a clinician, and you have to look at your business as an investment that you are making as a business owner or an investor because you could be taking money that. That you're making or borrowing, and you could put it in other things outside of your business that generate wealth.

And they, they, they generate long-term security financially, but in order for you to do this through the vehicle of a business. You have to look at the business as a business owner first and an investor in your own business. And this is where people start to really freak out and they get very nervous because now all of a sudden you have two options you can self fund.

That means you can save up as much money as you possibly can. You can self fund, and you can spend all your own money on the expansion of your space and your team and paying their salaries and all of that. Or you can borrow money and you can, you can do a leveraged [00:08:00] route, which would be via using debt.

Right. And there's two paths and we'll talk, we'll talk about both. I actually went the path of bootstrapping. We used all of our own money. We, uh, you know, paid for everything in cash pretty much, except for we had a small construction loan that was about, I think it was like $18,000. Um, we didn't have to do much, which was, which was good.

Uh, this also was like. You know, almost 10 years ago. So I don't think that you could have done a construction today that we did 10 years ago and, and have it for that much money. It'd be a lot more, I believe. But when you look at, you know, what we did, we spent to the tune of close to a hundred thousand dollars of cash we had saved on this expansion, on this, you know, sort of growth cycle.

Um, instead of taking debt out now, the pro of that was we didn't have to take any debt. We didn't have any interest to pay, we didn't have any risk associated with debt not being paid back. Uh, I guess, but the risk that we took was spending all of our own money on something that we didn't really understand that well.[00:09:00]

Uh, we didn't really understand how long it would take for a. Uh, for, for our staff members schedules to get busy, we didn't really understand what it meant to be able to market other services that we had built in that. Um, and we took the, uh, field of Dreams approach, right? The, if we build it, people will come, which by the way is a dumb strategy.

That is not a strategy and it is very stressful. I would not go that route. Like you have to have a very clear idea of, you know, how you're gonna fill somebody's schedule up the timeline that that's gonna take, how you're gonna leverage either your own cash or debt. Like it's, it's not a bill, and they will come.

Uh, strategy. Like for us, we, we were never more stressed out running a business. I've never been more stressed in my entire life than whenever we did this because for a six to nine month period, as we were going through a build out and brain staff on and delays and everything, like it was, everything went wrong.

That could have gone wrong. And by the end of it, we had very little cash left. Um, and we had been saving all of our money that we were making in the business. In the business, right. So this was also like. This was [00:10:00] our money that we was leaving in our business account. Instead of moving it over to any sort of like emergency fund, financial account personally.

Uh, so we were doubly stressed because we basically had doubled down on this personally and through the business because everything was just sitting there and it was being stored in the business. So this is one route. I think it's actually. The worst route to go. I don't think it's a good idea to self-fund the expansion side.

It's a great idea to self-fund the start. I don't think it's worth taking money out to start your business unless you're trying to, you know, invest in something, a piece of equipment you think is really valuable Information or mentorship is potentially an option as well. But like you should be able to start that business for very little money and then.

As you're growing your skillset and you're growing your ability to actually like deserve to run a real business, then you can take a big swing on yourself with expansion. But here's where you have to work on your mindset, because if you are very debt averse with good reason, by the way, because you have six figures plus in student [00:11:00] loans, and your monthly payment on that is, you know, equivalent to a, either a really nice car payment or a a or a small home payment.

Like that is something that is not, you know, it's fresh in your mind. It's something you think about and you have to take the mentality of being an investor to this, if you are going to then borrow money to expand your business. And I do think that is the right approach to take. And for me, if I was to do this again, if I could have gone back in time, I would've taken probably one to $200,000 out.

I would've funded the equipment and the expansion, uh, extra, uh, construction with that as well as had a very, you know, a sizable cash buffer. To get me through that first year in particular, before we could hire a second staff member and pay that loan back based on the cash flow of the business. And here's what I mean by that.

If I take a hundred thousand dollars out currently, uh, then if it's a a fixed 10 year loan, [00:12:00] uh, I'm probably gonna have somewhere between 12 and $1,300 a month of a repayment, right? So for me, all I need to do is say if I can take this a hundred thousand dollars and I can start to generate more. Then that amount net each month, so more than $1,200 a a month net because of what I'm reinvesting in, then I can pay the loan back with the cashflow from the business.

So I'm not feeling that I'm sort of taking a step back every single month. If you take out $200,000, it's roughly twice that, right? Let's call it 24. $2,500 a month. So you can do the math on that and what you can reinst. But for me, that cash reserve, that borrowed money that I'd now have a extended payment on, it would've made such a world of difference.

But my mentality was that I didn't wanna take any debt out. My wife and I had paid our student loans off our, uh, you know, vehicle debt. We had a home that we had a mortgage on, but other than that, we had no other debt and we'd worked really, really hard to get to that point. And we sure as hell didn't wanna go back into debt once we got to a point where we could expand our business, [00:13:00] but we didn't.

Understand that it was an investment. It wasn't debt for no reason, right? It wasn't a, a vehicle or, or I mean, student loans, obviously you're investing in your education. So I don't really look at that as a bad investment. It's just a big investment, right? That, uh, in this scenario. The investment could actually help you make significantly more than the income you would earn working as a staff clinician, uh, for the degree that you got.

So I think of this as an even more leveraged bet on your ability to increase your likelihood of financial freedom one day. And that's why I'm actually totally fine with these at this point as well as I recommend these all the time for people that are going through these stages because it accelerates your ability to do a couple things that you need to do in order to get past a very rough profitability stage.

So when we look at these stages, the startup stage, massive amount of profitability, very high, 70 uh, percent plus of every dollar you keep as net. If you go into this first growth cycle phase, we'll see this drop all the way [00:14:00] down to fif five to 15% in some cases, uh, uh, profit, which is way lower obviously, than where you're at.

I mean, I had somebody message me the other day. They were concerned because year over year they had paid themself like $30,000 less, but their business revenue, their gross revenue, their actual, like top line revenue had grown substantially. But they had. Now a fixed facility that was bigger, they had administrative help.

They had a staff clinician and they were concerned. They were like, I don't know if I'm doing something wrong. They're not doing anything wrong. This is the what happens whenever you grow a service-based business that's fulfilled by people, right? So you have business, someone services that business in this case sees patients.

You pay that person to do. So you have a space you're paying for. You have administrative staff that's helping manage, you know, the operations of the clinic. And that allows you to then get more people in the door to continue to see patients. And then you add another person and another person. And that's how these service businesses scale.

That's how they grow in a, in-person brick and mortar style, right? So you [00:15:00] can't skip from one person to four staff members, uh, immediately. Like it doesn't work that way unless you have. An obscene amount of volume, you might be able to do that. Um, but most people don't have that. It's very, very rare. So you hire one person, then you hire another person, then you hire another person.

And that stage between build out of a new space, getting administrative staff to help your first class, uh, staff clinician, and even that second one, that is where we see this sort of like really big dip in profitability. And that's very scary for people. Super scary for people because. You go from, you know, making great money in a lifestyle business, you can make great money.

Like I rem vividly, remember we were making $20,000 or so a month? Uh, just me, just me, you know, we had almost no overhead. We're probably 80% profit margins. Uh, so, so we were netting $16,000, uh, a month. We're paying ourself not even half that, right? Like we're paying ourself. Uh, [00:16:00] probably $6,000 a month. I paid my, I paid myself what my salary was when I was in the army.

The, the year that I left, I just kept my salary the same. So we were, you know, netting a hundred thousand dollars a year, uh, in our clinic as just me and a lifestyle business, which allowed us to save a bunch of cash, right? To save a ton of money. And then when we went and we hired, uh, our first staff member and our office manager, and we built out a space.

Multiple times. I thought I was gonna have to fire both of them. And the only reason I didn't do it was because I was so, like, I, I was so scared of having to do it. Like the only reason that they had jobs. And our office manager's still at our clinic today, by the way. And she's awesome. She's amazing. It, it's because I didn't, I literally was too scared to do it.

And, uh, eventually our clinic, as it continued to grow, we got to a point where. I mean, it, it was an absolute no brainer. These were very valuable people within the company and were able to add another person and another person and another person. But that stage, [00:17:00] especially that first hired, uh, of an, an admin as well as a, uh, staff clinician.

It's awful. It is so scary because if you don't know what you expect, you know, you think you're doing something wrong and I, I. I fantasize about going back to this little sublease office I had in a CrossFit gym and just going back to the good old days of me making money again versus me making no money and working twice as hard.

But in order for me to get to the stage where I wanted to take my clinic, where I didn't have to work all the time in the business, you know, I created time freedom for myself. And financial freedom I had to get through this phase and to do that bootstrapped is really, really sketchy. It's very hard and it's a, and and it's a, it's a very hard thing to do without absolutely exhausting all of your cash reserves versus if you take on debt, you can accelerate some of that too, because you can hire into the expected growth that you want faster.

You can bring people on faster, you can give them better compensation, uh, packages faster. And the only risk to this is the fact that you can't [00:18:00] actually. Fulfill on what you're telling everybody you're gonna do, which is getting people in the door, continuing to build a great brand, continuing to, you know, market your business, continuing to lead your people, hire great people, train great people, deliver a great service at scale.

And that is where you grow past this much, much faster. With, with, I'm not gonna say no stress 'cause it's still really freaking stressful, but less stress than if you're spending all your own money. And then when you run outta cash, you can't go to a bank to borrow money. It doesn't work that way. They're not gonna lend it to you like you're not as lendable as you are when you have a bunch of cash sitting there and then you borrow money.

Like this is the funny thing about banks, like they'll give you money when you don't need it and when you really need it, they don't want to give it to you. So. Make sure you're borrowing money in a, in a position of strength versus in a position of weakness, right? So as we look at this stage, you have to, you have to figure out which of these tracks do you want to take if, if you even want to go this route, if you want to have a lifestyle business and just stay small, there's nothing wrong with that, that's cool.

If you wanna grow past yourself and grow into [00:19:00] a, a much bigger clinic, a vision that you have, then my recommendation is. To really take a look at this debt path. But if that freaks you out, that means that you have a money mindset problem. I did as well. Okay. I'm not just saying that. I'm not saying you did.

I'm saying I did to many of us do because you're probably very, very debt averse because of debt that you've had to take on to get in the damn career field. It's normal. Maybe your family had debt issues. Maybe you, you had. You know, saw family struggles because of credit card debt or whatever else, and you're very averse to that.

But you gotta remember, you're an investor now, you're a business owner, now you're not. You're not living off of credit cards, you're not taking money out to buy groceries. You're borrowing money to invest into a business and people. So that you can grow a bigger business, create time freedom for you to focus on things outside of being directly in the business and just killing yourself to make this work, which is gonna have to happen for years, by the way, that you check that [00:20:00] box for years and eventually you get to a point where you can take a step back and.

You're working on the business, not in the business so much, and taking out loans to accelerate that is one of the best ways to get through that stage and still put yourself in a position where you know, you're, you're legitimately uh, still safe. 'cause, 'cause usually you have to keep in mind, worst case scenario, if it doesn't work out, doesn't work out, the business completely fails and you still have a, uh, a loan debt.

Let's take you a hundred thousand dollars out. Well. You probably already have debt from your student loans. Now you add a little bit more debt on top of that, right? With a personal guarantee, you have another $1,200 a month that you have to pay off, which is a lot of money, but it's not the end of the world, right?

It's not like you took out a million dollars to take a huge swing on a unproven business model, and then you pay that off over time, right? And you're still in the game. You're still not going in through a bankruptcy like you st. You. You still are able to provide for your family. That's a downside risk, [00:21:00] which it is not that terrible.

Honestly. The upside risk is you build a clinic that grows to multiple seven figures. You make more money than you ever thought you'd possibly make. You create time freedom. You create amazing jobs for people to get a chance to work in your clinic, make a great income, work with low volume, work with the niche that they want to work.

With you. Create a culture that's unique and special that helps your community out, you know, and you get to be a part of that and your family gets to be a part of that. And all these things are very positive. Uh, elements of having a local service business that truly helps your community is mission driven.

You're the one that has to take the risk to do that. That is what you signed up for. And that might mean that you gotta get comfortable with taking some loans out to expand past yourself to get comfortable with taking some debt out. To invest in yourself and your business and looking at this from an investor standpoint, not just a clinician who happens to have started a business.

Because if you look at it from that standpoint, if that's your mindset, you're never gonna get comfortable with this. You're gonna creep along and have terribly slow growth. You're gonna be stuck in this sort of like Death Valley of profit for a very long [00:22:00] time. And what you have to do is push through this shit as fast as you can so you can get over to the other side.

And actually have a team in place that is, has shared overhead costs and your profitability rises back up to where it should be in a much more healthy position. And you're not just stressed out all the time. Leveraging debt investing in your business can actually help you do that. This is in terribly challenging stage, one of the most challenging stages that you can go through.

I think. Starting is obviously very mentally challenging. Your mindset side is very, very hard. But this stage, this first growth stage, I think is the hardest part of these local service businesses that I've seen. It, it gets way more fun when you have more people. It gets way, it feels way less risky when you have more people and you have more profit is that profit is safeguards you from the ups and downs.

It happen when you have seasonal changes in the business. You know, people go. Visit family around Christmas. They buy presents instead of, uh, packages of business at pt. This happens every year. You know, somebody lose, uh, a staff member, you lose them. They leave, they go somewhere else. Well, if it's just you and one other person, you've lost a [00:23:00] hundred percent of your workforce.

It's not you. You know this, that's actually like forward facing and fulfilling. Versus if you have four people and one person ends up moving and going somewhere else, whatever it might be. That's 25%. It's way easier to stomach that. So you've gotta push the gas pedal, get through that stage, grow to at least three staff members and yourself as fast as you possibly can.

Get through that terrible profit stage, and you're gonna be in such a better place. And if you invest in your business the right way, I think you're gonna find that it's going to be less stressful, not any less difficult, like you still have a lot of work to do. It's still gonna be stressful, but hey, that's business is what we signed up for.

But you'll get there faster, you'll get there with less stress and more, uh, likelihood that you're gonna be able to achieve it, uh, in, in a, in a much, much more compressed manner and get to a place where the business becomes a hell of a lot more fun to own. So as always, thank you so much for watching. And listening.

Leave a comment if you have any, uh, questions or if you got any feedback for us on the YouTube channel. That's why we moved over there. We wanted to make sure we had a two-way conversation with you. We really appreciate you listening. We wanna help you out. This [00:24:00] is our mission. This is my profession. This isn't a business opportunity for me.

This is what I went to school for. I look at my degree every single day when I'm sitting here in my office. It's an important profession to me, and I wanna see it move forward and continue to progress. So we're gonna keep putting information out. We wanna help you. I hope that that's transparent and you feel that as well.

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