E867 | Why Cash-Based PTs Are Billionaires And They Don't Even Realize It

The Wealth Most PTs Never Count

There’s a kind of wealth that doesn’t show up on a P&L sheet. It’s not measured in profit margins, patient volume, or reimbursement rates.
It’s the wealth of meaning.

As physical therapists, we get to spend our days helping people move, live, and feel better. We get to rebuild confidence, restore freedom, and in many cases, change the direction of someone’s life. But after years of documentation, back-to-back evals, and endless notes, it’s easy to forget that.

That’s what this episode is about—a reminder from Doc Danny Matta that the work you do is worth billions, even if your paycheck doesn’t always reflect it.

A Lesson from “Patient Zero”

On a recent trip to visit PT Biz clients in Washington, D.C., Danny spent time in their clinics, observing the heartbeat of their businesses: the patients.
He met what he calls “patient zero”—those first clients who believed in the clinician from day one. The ones who still show up, years later, not just as patients but as proud advocates.

One woman got emotional as she described how much the clinic meant to her—how it helped her keep doing the things she loved.
No cameras. No marketing script. Just raw gratitude.

And that’s when it hit him: this doesn’t happen in other industries.
People don’t cry tears of joy in their attorney’s office. They don’t bring cookies to their accountant.
But they do for us.

The Real Value of What We Do

Most PTs underestimate the emotional and social capital they build every day.
The trust, the connection, the gratitude—it’s all priceless.

Sure, you might not bill $500 an hour like an intellectual property attorney. But those professionals rarely get to see the look on someone’s face when they throw their kid in the pool again after back surgery.
That emotional return is a kind of wealth that’s impossible to buy.

As Danny put it:

“The amount of personal gratification you get from helping others is worth billions.”

When Burnout Creeps In

After ten years in the profession, even the most passionate PT can start to feel like every eval is the same. The monotony of charting, scheduling, and EMR clicks wears on you.
It’s normal.

But burnout doesn’t always mean you hate your job.
Sometimes, it just means you’ve been focusing on the wrong thing—the work instead of the people.

Danny’s advice?

“If you ever feel like you’re getting burnt out, you’re focusing on the wrong thing. You’re focusing on the work. Not the people.”

The Unicorn Business

Think about it.
You have a career that lets you help people live pain-free, fulfilling lives—and get paid for it.
You get to do work that changes lives while building a business that supports your family.

That’s rare.
That’s a unicorn business.

When you combine meaningful impact with financial upside, you’ve already won.
And if you’re a cash-based PT who’s taken the leap toward independence, you’ve doubled down on both purpose and freedom.

You’re already a billionaire—you just count your returns in smiles, stories, and second chances.

Reframing the Day-to-Day

The next time you’re staring down a pile of notes or a packed schedule, pause for a second.
Remember that behind every visit is a person whose life is changing because of your expertise.
Every eval is another rep at making a difference.
Every session is another chance to give someone a piece of their life back.

That’s not burnout—it’s purpose.

Takeaways for the Modern PT

• Focus on people, not paperwork. Your presence creates better outcomes.

• Gratitude kills burnout. Start each day by remembering who you help.

• Celebrate “patient zero.” Those early believers are the heartbeat of your brand.

• You’re already rich. Stop measuring your worth by what insurance pays.

Tools & Resources

• 💡 MeetClair AI – A physical therapy–specific AI scribe that writes your notes so you can focus on patients. Try it free for 7 days → 

• 🚀 Free 5-Day Challenge: Learn how to go full-time in your practice and replace your income. Join here → 

• 🌐 PT Biz: Helping clinicians build high-performing, cash-based practices. Visit Website → 

Final Thought

You didn’t just choose a job—you chose a mission.
And every time you help someone get their life back, you earn something far more valuable than money.

So the next time you feel stuck or tired, remember:
You’re already a billionaire.
You just measure wealth differently.

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

[00:00:00] Hey, Danny Matta with PT Biz and I wanna share something with you. This should [00:00:05] be a reminder. Of just how lucky we are to do what we do [00:00:10] as physical therapists. So recently I was on a [00:00:15] trip to see clients in Washington DC and I had a chance [00:00:20] to co-treat with a few of the clinicians that we work with, which is [00:00:25] a, a treat for me, uh, because.

I don't treat patients anymore [00:00:30] unless they are friends and family that I see in my garage gym. [00:00:35] So I don't see a ton of patients. I have a, a couple, you know, uh, [00:00:40] a month at most. Usually it's some sort of sports injury with one of [00:00:45] my, uh, kids', friends or one of their, their parents, uh, or a neighbor. That, uh, [00:00:50] hurts their back picking up their lawnmower or something.

Right. And, uh, you know, I kind of take, I, I kind of take for [00:00:55] granted what the skillset is that we have. And many of you probably do the same thing where you're like, yeah, I [00:01:00] just know this thing and yeah, maybe it helps you not be in pain anymore or whatever. And. [00:01:05] We forget just how impactful it is on other people.

Now, [00:01:10] one of the interesting things about this trip was we spent the entire [00:01:15] day in our, uh, our clients' facilities, in their clinics, and I had a chance [00:01:20] to meet, I. Many of their patients. And in a couple of the [00:01:25] clinics I got to meet what I call like patient zero, you know? So this is [00:01:30] usually one of the very first people that worked with the clinician who owns the [00:01:35] business, and they're still around today.

They're like your biggest brand [00:01:40] advocate. Everybody has these, you know, everybody has that person that. Was influential [00:01:45] in helping you really grow your business because they told so many people how awesome [00:01:50] you were and they just really believe in what you do. And you've, you've done a lot for them as well.

You've really [00:01:55] helped them achieve something in their life or maintain the ability to do something in their life that's important to them. [00:02:00] And I had two different conversations with what I call patient zeros. And [00:02:05] one of the people that I talked to, she, she got a little bit emotional [00:02:10] when she talked about how.

Important this clinic was to her. [00:02:15] And it was interesting for, for me to have this conversation with [00:02:20] her. We, we weren't videoing anything or like that, this is just me and her having a conversation while she's [00:02:25] actually waiting to be seen by one of the PTs. And, you know, [00:02:30] I thought it was very, I don't know, it's, it is very memorable and interesting [00:02:35] to talk to somebody.

Who feels so strongly [00:02:40] about a business that they go to and you know, and are, are a, a [00:02:45] client of, right? Like, they're so strongly and emotionally tied to this business that [00:02:50] they, they, they literally, uh, they, they think of it almost as their own. [00:02:55] And that is a rare thing. I don't think people feel [00:03:00] that way about.

Most businesses, I don't think most people [00:03:05] actually get a lot of personal satisfaction out of the work that they do. They may sell [00:03:10] something or they provide some service or whatever because they need a [00:03:15] job and they, they, that's how they pay for their family's livelihood and they're, they, so they buy [00:03:20] food and there's nothing wrong with that.

I'm not saying that, uh, everybody needs to find their life's [00:03:25] passion in order to, you know, have a job. But I think that we are [00:03:30] uniquely positioned and we [00:03:35] have a level of personal satisfaction with [00:03:40] what we do. That is, it's, it's worth billions. [00:03:45] Like I don't, I don't even know how to put a price on [00:03:50] what we do.

And, and, and this is personally right now, we may not be the most [00:03:55] highly reimbursed. People on the planet, and you can make a strong case that [00:04:00] an intellectual property attorney shouldn't make more per hour than what maybe you make [00:04:05] helping somebody get back to throwing their kids in the pool over the summer.

But [00:04:10] that is what it is. It is how, uh, the economy works. They, [00:04:15] and, and it's the value that we provide, right, which is associated with the outcomes people get. [00:04:20] And that number comes from whatever the, the, the, the differences, right? Like that's [00:04:25] set in a number of ways, but. There are certain specialties within services or many other [00:04:30] things that are incredibly powerful and incredibly helpful.

They can be [00:04:35] reimbursed in many different, uh, ways and, and stages and, and ranges. [00:04:40] Well for us though, I don't think the same example that an [00:04:45] intellectual property attorney gets the same personal satisfaction out of helping somebody, [00:04:50] uh, defend a trademark disagreement that we do helping somebody. [00:04:55] Good over an injury, I can promise you they don't have people showing up in their office and [00:05:00] getting emotional over how proud they are.

Of the clinic that they just are, [00:05:05] they're a client of, that they've been a part of, and how proud they are to see, uh, the, [00:05:10] the development of the person that they worked with, both as a business owner and as generally a [00:05:15] person and the growth that they've seen. That doesn't happen in other industries very often.

[00:05:20] How many places do people bring fucking Christmas cookies back to like, think about your clinic at [00:05:25] the holidays? You probably had so many baked goods that ain't happening at At [00:05:30] your personal injury attorney's law office. Okay. That's not happening the same way it happens with us. We [00:05:35] have so much amazing personal satisfaction, amazing [00:05:40] interactions with people that are truly making progress, and I know I get [00:05:45] it.

If you do the same thing over and over again, it can feel monotonous and you can get burnt [00:05:50] out. I've been there. I've felt the same thing like if, if, if, if, if you're in the [00:05:55] profession for a decade, if you're treating patients for a decade, at a certain point it feels somewhat like [00:06:00] Groundhogs Day, and that's any profession, right?

Like you may love making burritos, [00:06:05] but dude, you do that for 10 years and you're gonna start to maybe feel like making [00:06:10] burritos. Burritos is getting kind of old. But here's what you gotta keep [00:06:15] in mind, and this is how I think we reframe the burnout that so [00:06:20] many people feel. And maybe you need to take a little bit of a break and then come back to it, and that's totally fair too.

But [00:06:25] I think that if you really focus not on the skillset you're doing, not on [00:06:30] necessarily the work itself, but on the people. Focus on the people. [00:06:35] And what the people are doing that we work with outside of the clinic because we don't get to follow 'em home, [00:06:40] right? Like you may see 'em out in the wild every once in a while, but you don't get to go [00:06:45] to their driveway with them when all of a sudden they can play a pickup basketball game with their kid because of the [00:06:50] work that you did with them.

You don't, you don't get to go on the half marathon [00:06:55] trip that they do with their buddies because now all of a sudden they can run 'cause their back doesn't hurt. You don't get [00:07:00] to, to, to do any of these things with them to see what they're, they're putting all this hard work [00:07:05] towards in real life, but it's happening.

And for me to have a chance to [00:07:10] sit down and talk to these just like huge advocates of these clinics that we work with, I don't know these [00:07:15] people at all. At all. First time I met 'em, but damn, they feels familiar. They, [00:07:20] they feel like the people that I work with, they feel like the people that you work with.

And if you [00:07:25] ever feel like you're getting burnt out, if you ever feel like it's redundant, you're focusing on the wrong thing. [00:07:30] Okay? You're focusing on the wrong thing. You're focusing on the work. You're not focusing on the people. [00:07:35] Because the people, they're extraordinary. They are the best part of the [00:07:40] entire business, of the entire profession.

Frankly, we don't know that going into it. I don't, [00:07:45] I don't think that's what we think, right? We think, oh, I'm gonna have a stable career. I'm gonna be able to help [00:07:50] people. That's cool. But you don't actually understand until you start [00:07:55] deeply working with people, having relationships with people for extended periods of time, helping people truly [00:08:00] get back to the activities they never thought they would do again.

You know? And the amount [00:08:05] of personal gratification that you get from that is worth billions. [00:08:10] Okay. Billions. And there's people out there that make a lot more money than you, that are [00:08:15] dead inside. Just hate what they do. And that is not us. There's people out there that [00:08:20] don't do a single significant thing for other people on a daily basis, and you do so much for other people.[00:08:25]

So next time that you're feeling kind of [00:08:30] burnt out, uh, I got a new eval. I don't know if I want to, like, you know, whatever, get [00:08:35] into this. I got this. Whatever documentation to do. Think about that person. [00:08:40] You're getting another rep to change somebody's life. You're getting another rep to help somebody get back to [00:08:45] something that they love with the people that they love.

And that is a rare thing, man. And, and, [00:08:50] and it just was such a cool reminder for me to see these people that I didn't know, [00:08:55] that were just raving about the clinics that, that they get to go to, the [00:09:00] people they get to work with. And. The, you know, the, the, they feel very [00:09:05] lucky to be a part of it, even though they are, they are our customers.

That's [00:09:10] pretty rare. I don't know a lot of other industries where that occurs, and I thought it's worth [00:09:15] highlighting that with you because you may, like me, I've gotten to a point where you feel a little [00:09:20] bit burnt out with seeing people, and that's normal. It feels monotonous. It feels like Groundhog's Day, but [00:09:25] man, the people are, are so worth it.

They're so worth it. It's the best part of the profession. [00:09:30] And the other cool thing is if you, if you do decide to do your own thing, like these business owners that, [00:09:35] that we were, uh, working with, they've all scaled their clinics [00:09:40] and are able to increase their income at the same time as [00:09:45] helping other people.

It's like a unicorn business. It's almost like you have a [00:09:50] nonprofit. Like you get so much personal satisfaction from, from a nonprofit. My and my [00:09:55] wife used to run nonprofits, and I'll tell you what. Yeah, she got paid awful. And we worked a [00:10:00] lot. I worked a lot of weekends with her, a lot of evenings. I was volunteer number one.

She worked a [00:10:05] ton of hours, you know, way more than an average work week and got, got paid [00:10:10] nothing. But we did it because the mission was important to us, right? The the [00:10:15] work, the, the people, the, the mission is, is, is why people stay in those [00:10:20] types of fields. Teachers why mission driven? They want to impact [00:10:25] young people.

You know, we look at these as service-based professions and, and [00:10:30] they are, you're a servant leader, right? But if you can couple that with [00:10:35] the ability to make a great income at the same time, it's a unicorn [00:10:40] business. Like, how lucky are we? Oh my God, don't forget that. Have gratitude for the [00:10:45] people you work with.

Have gratitude for the opportunity you have [00:10:50] to help people in the world like truly help people, and you get paid for that, and you have the [00:10:55] opportunity to get paid really well for that. That's something to keep in mind. Next time you're feeling a [00:11:00] bit frustrated and you know, stressed out and down. Don't forget [00:11:05] that.