E885 | One More Reason For You To Focus On Longevity

Longevity, Cash PT, and Where the Puck Is Going

In a cash-based clinic, patient experience is your real competitive edge.

Danny opens this episode with a simple contrast. While other clinicians are stepping out mid-session to type notes or staying late to finish charts, you could be the one staying present with patients, following up, and planning their next visits.

That is the operational advantage Claire gives you. It quietly handles documentation so you can make the patient experience better, improve retention, and keep your clinic running smoother.

You can test Claire free for 7 days here:
https://meetclaire.ai 

From there, Danny zooms out to talk about a much bigger shift he sees coming: the rise of longevity-focused, proactive health — and the role cash-based PTs can play in it.

1. From Early Cash PT to a Crowded Market

Back in 2014, when Danny opened Athlete’s Potential in Atlanta, cash-based PT clinics were rare. He only knew of one other in the city.

He opened anyway because he could see more of these clinics starting on the West Coast. A lot of health trends start there and move east. Cash PT was one of them.

Fast forward more than a decade:

• There are now many cash clinics in Atlanta alone.

• Some have grown to multiple seven figures in revenue.

• Some have sold to private equity groups or hospital systems.

That early move was about skating to where the puck was going, not where it already was.

Now he sees another puck moving.

2. The Longevity Wave

Over the past few years, Danny has watched interest in proactive health and longevity explode.

A few signals he points out:

• Functional and lifestyle medicine clinics are growing fast.

• Legit providers are leaving hospital systems to start proactive practices.

• High-end programs are charging tens of thousands per year for testing, training, and long-term health plans.

• More people are wearing devices like Whoop and Oura and tracking sleep, recovery, and daily strain.

He tells the story of a training partner he has worked out with for two years. They have tracked blood panels, InBody scans, and sleep data while building better habits around training, nutrition, and recovery.

The changes are obvious:

• Better lab markers

• Stronger physical capacity

• More visible muscle and energy

Friends who have known this guy for years cannot believe how different he looks and feels.

That is exactly the kind of change more people are starting to want help with.

3. Where PTs Fit in the Longevity World

Danny is not saying PTs should become functional medicine doctors.

Instead, he sees a lane that fits perfectly with what good cash-based clinics already do.

You can be:

• The movement and musculoskeletal expert

• The coach and accountability partner

• The person who translates confusing health trends into safe, practical actions

He has already done this informally inside Athlete’s Potential — reviewing lab results with patients, looking at sleep and wearable data, adjusting training plans, and supporting long-term habits while continuing to update exercise programs.

For some people, the relationship has moved from “fix my shoulder” to “help me stay strong and capable for the long haul.”

That is what a longevity offer really looks like in a PT setting.

4. Why This Is a “Blue Ocean”

Danny calls this a blue ocean opportunity for the right clinics.

You have:

• A growing number of people who want proactive help with their health and performance.

• Relatively few movement-focused, trustworthy providers offering structured, long-term support.

On the other side you have:

• Fringe offerings that are heavy on hype and light on science.

• Expensive programs that are out of reach for most people.

With a strong clinical background and common sense, you can help people:

• Understand basic lab markers and when to see primary care.

• Build better habits around sleep, stress, movement, and nutrition.

• Stay ahead of injuries instead of only reacting when things fall apart.

You can also partner with functional medicine or lifestyle medicine clinicians, letting each of you stay in your lane while serving the same patient over time.

5. Generational Health and the Long Horizon

One of the most powerful parts of the story is what has happened around Danny’s training partner.

When one person changes their health, the people around them notice. Kids see that training and good sleep are normal. Friends notice someone’s energy, strength, and mood and start asking questions.

That is what he calls generational health change.

PTs are in a unique position to spark that:

• You already see the full spectrum of aging and function.

• You know the difference between the 80-year-old who still moves well and the one who can barely get around.

The practical move inside your clinic is simple. Once someone’s pain is under control, start talking about:

• What they want life to look like decades from now.

• How long they want to be independent and active.

• The habits that will actually get them there.

From there, you can offer ongoing support — strength and mobility progressions, check-ins, simple lifestyle coaching, and regular re-testing — instead of just a one-off rehab plan.

6. Is This the Direction You Want to Go?

Danny is not saying every clinic has to build a longevity program.

If you like your current model and it is working, that is fine.

But he is clear that:

• The market is shifting toward proactive health.

• Patients are more aware and more willing to invest.

• Clinics that want to play in that space should start thinking about it now, not five years from now.

You can keep doing exactly what you are doing. Or you can start testing simple ways to extend your relationship with the right patients beyond discharge and into long-term health and performance.

Either way, the puck is moving.

Want help building the business side of this?

If you want someone to look at your clinic, your goals, and where a longevity offer might fit, you can get on a call with a PT Biz advisor here:
https://vip.physicaltherapybiz.com/discovery-call 

If you want your documentation time back so you can actually think, lead, and still be present with your patients, you can try Claire for free here:
https://meetclaire.ai 

And if you are still in the phase of going from part time to full time in your own practice and need a clear plan, you can jump into the free 5-Day Challenge here:
https://physicaltherapybiz.com/challenge

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

Podcast Transcript

Danny: 

[00:00:00] Hey, what's going on, doc? Danny here with the PT Entrepreneur Podcast, and today [00:00:05] we're talking about longevity again. This, this is something that [00:00:10] I've talked about, um, a handful of times in the last, uh, couple months, and [00:00:15] I keep coming back to this because when I, I, one of the things that [00:00:20] I try to really focus on is, um, the idea of like skating where the [00:00:25] puck is going.

What is it that, um. I see happening [00:00:30] in health and wellness, right? Where like, where we focus and where these businesses [00:00:35] exist, that is changing. That is, uh, that is, you know, things are moving towards, [00:00:40] and obviously it's not just PT clinics, but just health and wellness in [00:00:45] general. Healthcare, uh, and uh, physical health and training.

And, [00:00:50] you know, in 20. In 2014 when I opened, [00:00:55] um, athlete's Potential, the cash based clinic that I started with my wife, um, [00:01:00] you know, it was pretty obvious to me that. This type of healthcare was, [00:01:05] um, it was trending that direction, right? At the time I [00:01:10] only knew of one other cash based clinic in the city of Atlanta, but I'd seen, [00:01:15] uh, more and more of these pop up on the West coast.

And if you notice anything about, [00:01:20] there's a lot of trends that start on the West Coast and they move, they move their way over [00:01:25] to the East coast, uh, whether it be. Fashion or pop culture, [00:01:30] but health in particular is a, uh, a definite area that you see a lot of [00:01:35] sort of early adoption. Sometimes these things that are fads, they, they just fizzle out.

But a lot [00:01:40] of times these things start on the west coast and then they move east. And I had seen a, a [00:01:45] handful of successful cash-based clinics in major cities in California in [00:01:50] particular. One of those being, you know, one of my, uh, one of my mentors and one of those being a friend of mine who is down in, [00:01:55] uh, in San Diego.

And I felt confident that it was something [00:02:00] that we were trending that direction. Now, going forward to [00:02:05] now, um, this is 11 years later. I don't even know how many [00:02:10] cash-based clinics are in the city of Atlanta, but. When I started there, I was the second that I knew of, [00:02:15] and there's probably, I have no idea, many dozens, let's put it that way, [00:02:20] uh, of, of clinics.

So, you know, I was trying to skate where the puck was going. [00:02:25] Now when we. Look at trends within that space [00:02:30] that things have definitely changed quite a lot. Um, they're far more [00:02:35] scalable. They're true businesses. We've seen these businesses grow to, you know, [00:02:40] multiple seven figures. We've seen these businesses be able to sell, be able to sell, not just to [00:02:45] um, you know, individual buyers, but to be able to sell to private equity and, uh, [00:02:50] hospital organizations, which are.

You usually, I mean, you wouldn't have thought that would've been the [00:02:55] case, uh, at all 10 years ago, but that's happening. And um, it's because they're, [00:03:00] they're growing and they're trending in the right direction at that. Uh, and one trend that I've [00:03:05] been, uh. Sort of fixated on for the last year in particular is this concept of [00:03:10] longevity.

And part of it has to do with, I have a, I have a training [00:03:15] partner that I've been working out with now for, for like two years. And it's just been really interesting to see the health [00:03:20] changes this guy has made because we've been tracking his, um, blood [00:03:25] panels. We've been, uh, pulling, uh, or doing InBody [00:03:30] tests, uh, usually once a year.

And just looking at what the. The data looked [00:03:35] like he even tracked everything on a whoop for a year, uh, to help dial in some sleep habits and things. [00:03:40] And, uh, the, just the, the change that he's made physically, internally on his [00:03:45] biomarkers with his blood tests, uh, and just physically what he's capable of doing as far as training is [00:03:50] concerned, is insane.

And people that I meet that are friends of this guys, they just [00:03:55] like cannot. Believe how much healthier he is, how much more physically [00:04:00] capable he is, how much better he looks, how much more energy he has. Like all these things that we kinda take for granted whenever [00:04:05] we are staying on top of our health and wellness.

Um, but [00:04:10] you know, the, the good news for us is a lot of people don't understand those things. In [00:04:15] fact, the vast majority of the population does not understand those. But [00:04:20] historically, they haven't really been as interested in [00:04:25] proactive work. We're very reactive as far as our healthcare is concerned in the us.

[00:04:30] And, um, it's starting to change. And I'm starting to notice that, in fact, I noticed this [00:04:35] a few years ago when I started to see a lot of, um, [00:04:40] naturopathic, uh, physicians, uh, move, move into private practice. [00:04:45] And, um, you know, and, and, uh, functional medicine, lifestyle medicine, [00:04:50] the, the adoption of those, uh, has been.

Very rapid. It's grown a [00:04:55] lot. When I was looking for a, a functional medic medical [00:05:00] doctor, uh, years ago, just to be more proactive with my health, um, it was very hard to find. There [00:05:05] was one place in Atlanta. That I could go to. It was incredibly expensive. [00:05:10] And, uh, from there, even from that one office, there's been [00:05:15] a number of clinicians that have broken off and done their own things.

Not to mention people that have just come out of, [00:05:20] uh, more traditional settings. Even. I have family now. My sister-in-law is a fantastic nurse [00:05:25] practitioner in the Baltimore area. Uh, she like legit, you know. [00:05:30] Working and, uh, teaching in fellowship programs, um, has worked [00:05:35] in major hospital organizations like University of Maryland and John Hopkins and has true military [00:05:40] like trauma experience.

Uh, she, uh, recently in the last, you know, year and a half. [00:05:45] Uh, has started her own functional medicine medicine clinic, her lifestyle medicine clinic, [00:05:50] because of being interested in working with people more proactively instead of getting these super sick people to come to the hospital. And then it's very frustrating.

There's [00:05:55] nothing they can do about it. But, uh, just to see that, you know, firsthand that someone who's such a [00:06:00] legit medical provider then gets exposed to this sort of more, uh, integrative or and functional [00:06:05] approach and they can blend the two, it, it's amazing. It's the type of provider I'm looking for, and I'm not the [00:06:10] only one.

I'm not the only one because that industry is growing. [00:06:15] Tremendously. So there's some interesting stats that I, uh, I pulled just looking at this the other day. Like, what, [00:06:20] what does this trend look like? Where, where's this longevity trend going? And is this a fad? I don't think that it [00:06:25] is. I think this is actually something that is going to continue and it's a great place for you and your business, and [00:06:30] I'll kinda give you an idea of why I say that.

'cause this, this is, you know, when I'm being a bit redundant [00:06:35] about this and I'm, I'm beating the drum on this over and over again. I honestly think this is something that, you know, you. [00:06:40] You have time, like you can, you can work into, you know, adding elements of things like this to your [00:06:45] clinic, but, um, I do think it, it will end up being a big part of people's clinic that want to adopt this [00:06:50] style of, um, of, of an offer or of of work with, with clients.

So when we look at functional [00:06:55] medicine clinics right now, the, the numbers in 2023, uh, is estimated that they account [00:07:00] for about like $28 billion. In, in, in total, uh, you know, rev size of the [00:07:05] market, total revenue. Uh, so $28 billion is the size of the market. And by [00:07:10] 2033. It's expected to grow to roughly 200 and, [00:07:15] uh, $30 billion.

So, you know, almost a, a 10 x, like a a nine [00:07:20] to 10 x growth, uh, over the decade. That is a lot. That's an incredible [00:07:25] jump in. Um, the amount of clinics that they expect, the amount of people that are interested in going that [00:07:30] direction. And I, I would ask you yourself, right, do you notice this in your own area?

Do you notice that [00:07:35] people are looking more for this sort of proactive partner for their health and wellness? Are they interested in looking at [00:07:40] their blood panels? Are they interested in doing something that looks at their, you know, gut microbiome? Are they, are they trying [00:07:45] to. Have proper supplementation and be proactive about their health.

Are they, they asking [00:07:50] you about, you know, things like VO two max tests and uh, and, and really like trying to stay [00:07:55] ahead of things. Do you notice more people wearing w wearing wearables, uh, ora rings and whoops. [00:08:00] And, uh, tracking their data, these health metrics, and you can have your own opinions on that, but it's generally a good [00:08:05] thing because it means they're being more aware of their health, uh, and what they're putting in their bodies and the sleep [00:08:10] they're getting and all that.

So knowing this and knowing that it's trending that direction and knowing [00:08:15] that, uh, there's, uh, there's, there's gyms and, and, uh, training facilities around the [00:08:20] country that are charging 40 to $75,000 a year to do [00:08:25] work proactively in, in a number of different sort of capacities with these programs. Um. [00:08:30] Y this is something you have to ask is do you have the skillset to do this?

And not [00:08:35] necessarily to be a functional medicine practitioner. I'm not saying that I think that that is not our [00:08:40] wheelhouse. That is not what we should do, but what we should do [00:08:45] is. Be able to fit in a role where we are the [00:08:50] accountability partner, the quarterback of their health and wellness, the people that can understand the, the different [00:08:55] elements of, uh, health and nutrition and stress management and sleep, [00:09:00] and be that that educator and that accountability partner, the people need ongoing to really learn how to [00:09:05] take care of themself.

And we know that of all the problems people have. [00:09:10] The, the, the things that are gonna stop them from being able to do the physical activities that they want [00:09:15] are gonna be musculoskeletal pain, right? I mean, it's, it, it, [00:09:20] it stops people that wanna go to the gym from gonna gym stops. People who wanna be more active from being more [00:09:25] active and they end up in our facilities because we deal with injuries.

Um. Now [00:09:30] from there, once we, once we realized what the root causes, it very well could have something to do with the fact that you're [00:09:35] not sleeping at all, you're not drinking any water, and you eat, you know, uh, a horrific [00:09:40] diet and you drink a lot like. It's not rocket science to say like if [00:09:45] you're putting all these negative inputs in the body, what do you expect is gonna be the output physically for [00:09:50] you as you move around the world?

Uh, it would be like you putting like terrible fuel in your vehicle and wondering why [00:09:55] you keep having like, problems with your engine. Uh, it's the same thing. So people are more [00:10:00] interested in learning about that now though, and I see it over and over and over again. And even at athletes' Potential. [00:10:05] This is something that we are, um, you know, beginning the, the, the, the [00:10:10] sort of build out process of a, of a true longevity ongoing program.

A, an [00:10:15] offer that we can have on the backend of, um, you know, of, of injuries that [00:10:20] we work with to help them learn how to take care of their body long term. Now, this could be. [00:10:25] Uh, a very simple, you know, process where you just work with these people in a, in an [00:10:30] unstructured way. I did this for years. Uh, in fact, I would pull blood panels through, um, inside Tracker [00:10:35] and I would have people share their, their, you know, sleep d data with me on whatever it's that they [00:10:40] wanted to track.

And we would talk about you some basic changes in, um, in what they were [00:10:45] eating and hydration and, and we would do this along with me, sort of updating exercises that they would [00:10:50] do. And for some people I would work with 'em for years, uh, and we would. Come in and sometimes they'd have questions about some [00:10:55] stuff they saw on, you know, social media or they read an article about something and they would ask me my opinion [00:11:00] on it and I could help distill whether you know, what the validity of those things were.

Because we [00:11:05] understand, you know, how to look at research studies, how to look at whether something is actually like [00:11:10] truly valid or something is just sort of like good marketing for the average [00:11:15] person. They don't know that. But net net, at the end of the day, if you can help [00:11:20] somebody change their health long term.

And they want. [00:11:25] Help doing that. They just kind of don't know what they need or where they should go. [00:11:30] That is what I consider a, a blue ocean. It is an area where you have, you have [00:11:35] people that are potential clients that are very interested and you don't have a lot of people serving that audience [00:11:40] yet. Not, not a lot of people serving that audience.

I would say in uh, in, in our community, [00:11:45] you have a lot of. Uh, fringe healthcare, things like medical [00:11:50] spas, peptide clinics, uh, like very out there, [00:11:55] uh, integrative and functional medical clinics. I'm, I'm not talking about the people that are like legitimately, they have a [00:12:00] medical background. I'm talking about, you know, the people that are telling you to sleep with crystals under your pillow or something.

[00:12:05] Like, if that's your thing, go for it. But like, it probably ain't gonna help you much. You might as well just get better sleep, [00:12:10] take that shit outta there. And I think that for us, having a, like actual medical [00:12:15] background. Going to an actual accredited school, understanding how to do [00:12:20] research, understanding what is safe, what is not safe, like cutting out the bullshit for [00:12:25] people and helping them learn the basic skill sets of how to take care of themself, which you may not know actually, [00:12:30] they don't teach stuff, uh, in school to us.

And I took this for granted whenever we hired our first staff [00:12:35] clinician, and I just expected that she knew this stuff and she, she, she didn't know a lot of the stuff that I was doing. She [00:12:40] didn't know how to read a, uh, basic blood panel. She didn't know when she needed to pound somebody too. Primary care or [00:12:45] understand this sort of, uh, you, you know, primary care or musculoskeletal position that I [00:12:50] ha was in when I was in the military.

I just assumed that's what we did as a profession. So there is a learning curve there that [00:12:55] that can ha can happen and needs to happen if you decide that you want to go that direction. Um, and you maybe don't even need to do that. [00:13:00] Maybe you just need to find a functional me medicine clinic to be partnered with where you can really handle [00:13:05] more of the movement based things and they can handle more of the, uh, the, the, the, the deeper dive things on the, on the actual [00:13:10] like healthcare side.

Um, and that's a great combination as well. But either way. Being able to put yourself in a [00:13:15] position where you have an ongoing relationship with people is fantastic for the clinic. It's fantastic for the [00:13:20] clinic. It's great for your business. It's great for the patient, and it's great for you because you get to [00:13:25] then have this ongoing relationship with somebody where you're not.

You are not just trying to solve a [00:13:30] problem anymore, so your mental bandwidth is not exhausted as much as just a bunch of evals. [00:13:35] Um, you're working with people that are truly like making progress. They're changing [00:13:40] their, their, their physical health. You're adding years to their life. Honestly. [00:13:45] You're adding years to their life.

And not only that, but keep in mind. These skills that they're learning. Like, like my [00:13:50] friend who, who I work or work out with this was just like, you know, I don't program for him, he just does what I [00:13:55] do. He just comes to my garage gym six o'clock in the morning, you know, Monday through Friday. That's what [00:14:00] happens.

Um, and what I've seen is his entire [00:14:05] family is healthier because of it, which is crazy. But, but, but at the same time, not really, because [00:14:10] we know that kids, uh, what they see. Is just what they [00:14:15] think is normal. So if your kids just see you chain smoking and drinking a bunch of beer, they think [00:14:20] that's what's normal.

If your kids see you, uh, prioritizing your sleep [00:14:25] and exercising and you know, getting more movement in. [00:14:30] And, you know, managing your stress, they think that's normal. That's just what [00:14:35] they see. So it's what we call a generational health change. So not only are we impacting one person, but we're [00:14:40] having a ripple effect across everybody that has a connection with this person.

I, I can't tell you how many people I've met that are [00:14:45] friends of, of my friend who have improved their health. Because of it. Uh, [00:14:50] j just from him being an example of, oh, man, if so and so is doing it, like, maybe I should look at doing some of [00:14:55] this as well because they, they, uh, they, they trust him, they respect him, [00:15:00] uh, and they've seen what it's done for his life as well.

So keep this in mind. These are all the [00:15:05] positive benefits of you taking a step to really say, okay, I wanna start to have a [00:15:10] conversation with people after their knee doesn't hurt anymore. About what is it that you are interested in doing, [00:15:15] you know. Uh, how do you, how long do you wanna be functional for?

How long do you wanna be able to do the things [00:15:20] that you like to do? And really like widening that, [00:15:25] that time horizon for them to help them think long term. Most people are literally [00:15:30] just thinking about what's happening next week, and if you can help them think about like what you want your life to look like [00:15:35] when you're 80 years old.

Like, have you ever met an 80-year-old that is just. [00:15:40] Getting around the world, no problem. Sharp as attack, you know, like just [00:15:45] living the life that they wanna live independently still and still physically able to do things that they want to do within [00:15:50] reason in life. And then at the same time, have you met somebody who is dependent on everybody [00:15:55] else around them, can barely move around and is.

In many cases, probably [00:16:00] very, feels very isolated, depressed, and it feel, it feels like they need other people to help them [00:16:05] all the time. And that's not a great place to be. And as physical therapists, we see the entire [00:16:10] spectrum of this. We can relate to this because, I dunno about you, but I've [00:16:15] worked with many people that are, that are older and I've seen people that are on both sides of [00:16:20] that and plenty of people in the middle.

And when I think about what I [00:16:25] want, I want to be. On the, on the functional side of that, I wanna be the person that's [00:16:30] able to do the things that I wanna do with, if I am lucky enough to have [00:16:35] grandkids, maybe even if I'm around with great grandkids, I wanna be able to interact with them and be, be [00:16:40] around and be physically able to, uh, you know, enjoy the world with them and have the energy to do so.[00:16:45]

So I make decisions today in my health based on what's I'm hoping happens, [00:16:50] you know, 40 years from now. And who knows what happens in between. We can't, uh, we can't [00:16:55] necessarily. Uh, with certainty say, but we sure as hell can decide whether we're going to put, [00:17:00] you know, put it back into our body or we're just gonna keep taking, taking it out and based on how we [00:17:05] live and the habits that we have, and a lot of people are looking for help with that self.

This sounds like something that [00:17:10] aligns with. You and your business. I think this is very much an area for you [00:17:15] to continue to pursue looking into and thinking about how would you wanna work with somebody, uh, in [00:17:20] this manner. This is something that, like I said, there's, you know, it's something that we plan on testing this year.

[00:17:25] It's something that I see people in our mastermind already having these conversations with their clients about, looking at what [00:17:30] they would do. And one size doesn't always fit all, and that's great. And that's what's awesome about having the creativity to do these [00:17:35] things. Um, but it's trending that direction.

It's happening. Maybe it's a fit for you, maybe it's not, [00:17:40] but this is definitely one of those things where I see where the puck is going. You can [00:17:45] skate there if you want. You can continue to do what you're doing. If you like that and your business is doing great, awesome. This [00:17:50] may not be the right fit for you, but either way, I think it's worth addressing again because, [00:17:55] uh, you know, it's a, for me, this is, this is just too obvious that this is going to continue to grow [00:18:00] and become a bigger part of this sort of non dysfunctional healthcare system that we have [00:18:05] is very.

Reactive and people are starting to realize that they're gonna, they're gonna have to take that into their own hands [00:18:10] if they wanna be proactive with their health, and that can be a great place for you to live as [00:18:15] well.