presentation if it does it
means I'm doing it wrong um
first thing I want to ask
is you made the jump from
college and professional
baseball to healthcare is
that right first of all yeah yeah
Yeah.
And honestly,
I wish I had a story that
said that I was I put all
this thought into it and all that stuff.
And I was but honestly,
I was I studied business in
college and I was
definitely a baseball
player before I was a student.
So yeah.
I found myself kind of all over the place,
kind of taking the classes
that my academic advisor
told me were the easiest
through undergrad.
Yeah.
So I ended up getting
drafted in two thousand six
by the Astros.
I was about.
two semesters away from
graduating with a degree in
interdisciplinary social
studies uh which was
definitely uh not on the
track of going to physical
therapy school so no fast
forward a couple years I
ended up getting hurt tore
my bicep tendon lost my
baseball career and
kind of in that transitional
period where I'm like oh
like what do I do now with
my my life I was in orlando
doing at spring training
kind of knowing that I
probably wasn't gonna have
a fruitful baseball career
at this point um but I was
doing all my rehab um and kind of just
So they started having that conversation.
Like, what do I do next?
And then I was hanging out
with the physical therapy
team there with the Astros
and they seemed like they
were having fun and, you know,
it was great.
And I was like, man, this,
this sounds pretty cool.
You know,
what the heck do I have to do to
become a physical therapist?
So, and also long-term,
I really wanted to own my own practice,
um,
wanted to have my own business,
I should say,
whether or not it was a
physical therapy practice
or some other kind of business.
So those two things aligned.
I said, okay,
so I can start my own
practice in physical therapy.
I can go to school.
And so I ended up going back
and I took all of my prereqs.
I took all the sciences in one year.
I took
All my core sciences in the fall,
the second one in the spring.
Actually,
I wasn't allowed to take them all
at the same college because
they told me that that
would be a recipe for disaster.
So I had to piece it together.
I had to take online physics at like FIU.
I had to do all kinds of shit to get done.
And it's funny how at that
point I spent the last like
four or five years telling
my parents how hard college
was in order to get like C's and B's.
And then, uh, when it comes,
comes time to like where
it's all on my own dime and I,
and it's all on my own schedule.
It's like, wow, I can get straight.
I had to get straight A's by the way,
and all those sciences in
order to actually get my GPA up to,
to get accepted into
physical therapy schools.
And I did it.
And, uh,
I will forever tell my kids
they are full of shit if
they tell me that they
can't get good grades in
college because it's not that hard.
You just have to actually
study and not go out every day.
Good for you, man.
That's not an easy hill to climb.
Similar background where
journalism and
communications degree and
then second career degree.
decided to go into PT and they were like,
okay, well you need nine prereqs.
I'm like, well,
how many out of those nine?
And they're like, eight,
you need to get eight.
I'm like, great.
Awesome.
Like, let's do that.
like let's figure that out
and I was running a radio
station at the exact same
time like I was running two
radio stations sorry
technically so I was on the
air with like a physics
book like you like on the
air with a physics book and
interviewing like shinedown
or something this is back
in like the two thousands
and they're like what's the
deal with the physics book
I'm like oh it's just
really heavy it's doorstop
don't worry about it but
meanwhile you're being like
Yeah,
like I had like a C average or a C
plus average.
But when you want it and
it's something you want,
like baseball or PT,
suddenly you clear out
everything that is not
helping you achieve that.
And stuff doesn't get easier.
I think it gets simpler.
And those words are different to me.
Simple, not easy, right?
Just get A's in these classes.
Well, that's simple to say.
Not easy to do.
But when you're like, okay, well,
what do I need to remove
out of my life to make sure
that happens is not a skill
everybody possesses.
Not everybody possesses that.
And it's really hard to do
until you have to do it.
It's almost like in my life,
I've succeeded when I had
to do something that I wanted to do,
but this is the only path forward.
It really is amazing how
many excuses you can make
for yourself and say like, wow,
this is too hard.
But it's just like when you
focus yourself and you
don't have all these outside distractions,
it becomes very clear what
you have to do and you kind
of reverse engineer it.
Like, what do I have to do to get an A?
Well,
I got to actually show up to every class,
and I got to take notes,
and I got to rewrite my notes,
and I got to tape record
the lectures and listen to
them on my way home.
And then all of a sudden,
it becomes pretty easy.
Yeah.
Well, what lessons from sports?
Because we skipped over the
fact that you were like,
what position were you, by the way?
I was a pitcher.
Good for you, man.
So what lessons from sports still got you?
Yeah.
Honestly,
the biggest takeaway I found from
sports was that the team
approach to things is super important.
It sounds kind of cliche, but your team,
I've been on teams that we
had so much talent,
but we weren't kind of
firing together as a team.
The coaching staff didn't really
breed that culture of team
mentality uh well and we
were just we were good but
we were mediocre and but
then I was on teams where
we were we were decent
talent but we were an
unbelievable team just
because of that the work
that we put into making
sure that we all were
fighting for the same goal
you know and um and I kind
of took that and I really
wanted to replicate
the team approach.
One,
I thought that it was the best way to
do things in business and
physical therapy.
But two,
I also thought it was a much more
enjoyable culture to have.
So I did my first or second
clinical rotation in an
outpatient setting.
I forget which one it was,
but it was one of those
there was no team mentality there.
There was your patient,
whichever one you got lucky
enough to treat on the
first day was the one that
stayed with you the whole time.
You couldn't really
collaborate with your peers
the way you should be able to,
because if anyone ever
recommended something to
you about your patient,
then it was taken as an
insult that you didn't know
what you were doing and
stay away from my patient.
And without saying it,
that's kind of the vibe I was getting.
Everyone kind of went off
into their separate corners
of the treatment room and
treated their patients.
outside of earshot you know
and it was just miserable
and I thought you know what
I want to open up my own
practice I'm going to do
this pretty quickly after
graduation and I don't want
this to be the case you
know and I actually had a
good comparison to what I
wanted the clinic that I
actually ended up buying
was the one I was working
at before all this as a tech so um
And there was a team there
with four or five people
that worked together unbelievably.
And we kind of shared
patients and we talked and
it was a mentorship
mentality and it wasn't done by design,
I don't think,
but it just happened to be that way.
So I remember taking that
mentality that we had in the clinic
and my job,
and I kind of tried to reverse
engineer that into an SOP
that we could use for
scalability in the business
that I started.
So you had an example of
what you did want and what
you didn't want.
I don't think you need both,
but I think you need one of them.
Like, are you lucked out?
You're like, okay, don't want that,
do want this, great, got it.
I think if someone's listening,
I don't think you need both.
It sure as hell helps, right?
But I think you need one of them.
It doesn't matter if it's
the one I don't want.
Well,
I feel like you might need more than
that.
I had a couple of different
clinical experiences.
I was like, whatever that is,
that ain't it.
I think I needed more than that.
All right, well, what do you want?
Now you need to play the opposite game.
Chip away everything you don't want.
So that's pretty powerful.
And you're able to do it
Again,
that's simple but not easy to create
something that you're like, yeah,
this smells and tastes and
feels like I want it to.
It's simple.
And that's a different job
than being a clinician.
That's a totally different job.
A business owner is a
totally different job of
being a clinician.
So you're building – and you
can give us the stats.
You're helping grow a
fast-moving network of
clinics now in Florida, right?
Give us the back of the baseball card.
Stats.
Yeah.
So we started in twenty eighteen.
I actually bought a practice.
And, you know, Tony Meritado.
I bought Tony's practice
down here in Florida.
So.
Yep.
So connecting those dots for
you all together.
He and by the way,
I've only met Tony in
person a couple of times
because really by the time
I started as a tech,
he was already moved to
Ohio and he is already retired.
already opened up his other
practices up there and this
was his remaining practice
down in florida um that so
his team was kind of very
self-sufficient and uh he
was looking for a tech
position and I I don't know
if I reached out to him
cold or he reached out to
me I don't remember but uh
but I got that job and then
timing worked out to where
the PT that was there was
moving out of state about
the time I was graduating.
So I literally started on a
temporary license in her
like last month before she
moved and then passed my boards.
I was the only PT there from
out of the gate.
We had like a part-time PT too helping,
but
But it worked out great.
Um, I did talk with Tony a lot, you know,
Tony.
Tony's a spreadsheet guy.
He had a bunch of that kind of thing.
So I met with him regularly
about every quarter about
what the business was doing.
And so I kind of got my feet
wet with that.
And then I just started,
it just opened up Pandora's
box on me just
self-educating as much as I
possibly could, which was great.
But what I did was about three months.
So
One key part of this story
is I was going to take on
the purchase of Tony's business.
And that was a handshake him
and I had when I when I started with him.
I was like, look,
I want to own my own practice.
He said, perfect work for me.
I'll sell you my practice
when you're ready.
I said, OK, great.
So a couple of years into it,
I called him.
I was like, hey, I'm ready.
And he's like, OK,
let's start talking about it.
Meanwhile, um,
the biggest thing in my head was like,
I want to have an
orthopedic orthopedic focused, you know,
an outpatient clinic that, um,
and it's very it's very
tough in our area I don't
know if it's this this way
all over but it's very
tough to have a single
location where you're
trying to cater towards
orthopedic surgeons that
might have a radius of
patients coming from maybe
twenty or thirty miles away
so why is that is the
radius the issue or is it
the size the issue is they
don't they don't want to do
the thinking of like okay I
know justin down in osprey
florida has a really good
little micro clinic
But I have patients coming
from seven or eight
different towns around them.
So now I have to do the thinking.
Do you live in Osprey?
Because if you live in Osprey,
what they're going to do is
they're going to send to
their best provider that
has their zone covered.
So they're sending to our
competitors because they
have eight or nine locations in the area.
And it makes them not think.
So you can pick off a couple
of ones that really...
it's most of the time, not the high volume,
you know,
ones is the ones that are more
micro niche clinics or, you know,
that really care about their patients.
I should say that, you know,
and maybe they'll send you on purpose,
but if you really want to compete,
then you need to have multiple clinics.
So right away, I was like,
how am I going to afford to
fund multiple clinics right away?
You know, self fund.
So it kind of fell into my lap.
but a patient of mine
ex-business guy he shows up
in the clinic pissed off at
the guy down the street
because uh he wasn't good
at what he was doing and he
said the wrong things and
he comes into us um kind of
all flared up and thinks
physical therapy is a joke
and starts telling me what
to do and I kind of
listened to him and I said
all right brian well
I appreciate your passion here,
but here's what we're going to do.
Here's, here's your,
your path to get better.
And you get you back on the golf course,
get you back active.
And he's like, holy shit, this is great.
You know?
So fast forward about twelve weeks,
you know,
he fell off his steps and broke
his femur after having one
too many drinks and trying
to take a leak in the
flower bed in the middle of night.
But
Speaking of that, cheers, by the way.
I got my beer.
Cheers, cheers, cheers.
I got a minute left.
And so he...
He said, so, you know,
this guy was a seasoned
business professional, retired to KC Key,
was very successful in his life.
And I love picking the
brains of my patients.
So once I found out that he
was this kind of guy,
I was telling him what I was going to do.
I was picking his brain
about how he did his thing.
And all of a sudden, on his last day,
he was discharging.
He says, Justin,
will you come to my house
after you get off work?
I want to talk to you about something.
I was like, okay.
Go to his house.
He says, look,
I've been paying close
attention for like the last
eight weeks or so about
your leadership style,
your team you have there.
I've been doing my research
on the profession and I,
I don't need to do this,
but I would like to, if you would like to,
I would like to back you
financially and help you
get to your goal to where
you can really make an
impact in the orthopedic community.
and we can have a clear exit
plan in five or six years
to where you can buy me out
and we can go on.
So my wife and his wife and us had
had a couple of dinners
together talking about the deal,
how this would work.
And my wife came home and said,
let's do it,
because that was her biggest fear, too,
was putting this thing
financially up front when
we're only thirty years old or whatever.
So now you fast forward seven years.
Open seven clinics in surrounding areas,
also mobile therapy in all seven areas.
We have about a ten-person
mobile team doing home physical therapy.
And we own all of our buildings.
So we've built a tremendous business.
We're averaging about one
million dollars worth of
revenue in every clinic.
We're just kicking ass, man.
Wow.
So let me ask you a very
Tony Meritato question.
are you a real estate
company that does physical
therapy or are you a
physical therapy company
that does real estate?
Cause it feels like the two
are so closely tied,
especially with your model.
Yeah.
I mean, I kind of both.
I mean,
I do think we have a very good
successful actually
physical therapy business here.
You know,
but one of the reasons why we
purchased the,
the real estate was because
it just financially made better sense to
um for us um then it was
renting in our area I mean
we were paying close to
double what what we we
could own the actual
property for in osprey
where we started we were
paying ninety thousand
dollars per year and you
know rent and we we could
own that property for half
that you know so it's a
weird weird thing but uh
and with brian helping us
and the bank banking
relationships he you know
actually brought to the
table we could afford to get these loans
And then I think we just
kind of lucked out with a
low interest rate
environment as we purchased
most of these properties.
So we ended up, but also to your point,
I look at it as if the
business can pay off the
real estate for you,
then it's a good retirement.
I think a lot of PT practice
owners are stuck with like, okay,
I ran this practice for twenty years.
now I should be able to sell
it and retire and then from
my experience trying to buy
these practice owners you
know they think they have
something that's more
valuable than it is most of
the time some and uh and if
you didn't have that extra
real estate over twenty
years making money for you and also
and appreciating in value
and your company paying it
off for you then all of a
sudden now you have an
asset that you know you can
actually retire with so so
that is my long-term goal
too is to is is to to have
an actual real estate
portfolio that I can retire from also
Yeah, it's the way to go.
So I love asking these types of questions,
which is biggest challenge,
biggest surprise in doing this process,
besides Brian falling off
into his flower bed,
which was a good serendipity, right?
Yeah, yeah.
And what's actually cool about that,
to kind of wrap that side of the story up,
is I'm actively buying him
out as we talk right now.
We're supposed to close next month,
and I'm going to own, oh, wow.
hundred percent of the
company and our plan worked out well.
So it's great.
But as far as challenges go, I mean,
I'm sure a lot of people
have had these challenges.
I mean,
I'll talk for ten seconds about the
reimbursement declines and
the hiring struggles that everyone has.
Those are kind of like the
table fare of having a
physical therapy practice
everyone deals with.
So those are real struggles
that we've had to work through.
But for me, the biggest challenges are
building a team of over
fifty employees at this
point people because I care
so much about everyone
being happy and everyone
wanting to work for this
company and us being
successful that you know
it's a it's it's a very
there's big swings in this
business when it comes to
to managing employees you
know one day everything's
going good the next day
it's not and you you really
wear it on your sleeve I
mean my my beard had no
gray in it um a few years
ago you know so a lot of
the stress that I I bring
home is employee related
and I don't want to say
that employees are bad
that's not what I'm trying
to say here it's just that
you end up you know
With that many employees,
everyone's dealing with
their own personal stuff.
Everyone's dealing with
their own health issue,
their own financial issue.
And you kind of have to like
wear that with them.
If you care about your team.
That's what we started this
thing by saying,
being a clinician and being an owner,
a boss, a leader,
they're two different jobs.
Playing first base is
different than catching, right?
I played both positions and
like catching was a super
thinking position.
I didn't think about that.
I just thought it was the
idiot with the shin guards on,
but you have to sort of like, no,
I can see,
I'm seeing the field from
behind the plate
differently than the first baseman.
I can see the infield.
I can see the out.
It was unique.
You're the only player facing that way.
You quite literally are the
only player facing that way.
Everybody's facing home plate.
You're looking their way.
So being a leader is quite different.
When I was in college,
my uncle owned bars in New York.
And when I was in college,
what are you going to do next?
And what are you going to do
when you grow up?
I was like,
I want to own a bar like Uncle Frank.
And then I worked for my uncle.
He was smart enough to be like,
come work for me.
And at the end of the summer, he was like,
what do you want to do now?
I'm like, I want to go to bars.
Like I don't want to be in a bar.
I saw it, but it was good.
Right.
Like go jump in different.
Cause what I saw was, you know, cocktail,
like let's hang out and it's party time.
And there were some of that,
but the actual business of
a bar restaurant was like
this other stuff that I was like, yeah,
not for me.
Like cool.
Great for uncle Frank.
And I think uncle Frank knew that,
but if he tried to talk me out of it,
I probably would have resisted.
But Uncle Frank was like,
step right this way.
Now, being a bartender two,
three nights a week, great job.
But owning the bar, different job.
Playing the role or playing the coach.
And there's a real stress
when you're dealing with –
when you feel responsible
for other people's livelihood,
it adds a real layer of stress.
Oh, I bet.
I think a lot of people can
understand that.
And I'm not trying to say it as if like,
oh, you know,
you shouldn't start your own
practice because I would do
it a hundred times over again.
But, you know,
it's the kind of stress that
wakes you up at like twelve
thirty in the morning and
doesn't let you go back to sleep,
you know?
So, yeah.
Sure.
All right.
So let's talk about
leadership since you
brought it up a couple of different ways.
and focusing on leadership
and letting others shine I
think some people think
being a leader is being the
one who shines right but
ironically I think we both
agree where it's more about
making other people shine
and listening to their
problems how do you
actually build leadership
skills inside a clinic team
not just for yourself but
for others is there an
approach you have you said
brian was slowly watching
your leadership style what
when it what goes into that
Well,
I think you have to make a conscious
effort not to, from the very beginning,
not to build a brand around yourself.
Some people have successful
business models where they do that,
where they build their
brand around themselves,
but they're probably hard
pressed to find good
leaders willing to step up
and help grow their practice.
so what you have to do is
really focus on having a
brand your business having
its own brand and then
building your leadership up
to support that and and
doing things instead of
micromanaging people and
saying like here's how I
want you to do it you say
hey I expect you to come on
board and have better ideas
than I have that's my
expectations and I want to be the person
that pushes all the hurdles
out of your way for you so
that you can just like
sprint past me and get,
and get first place, you know?
So I feel like that is what
I've gotten good at is when
someone has a problem, I'm like, let me,
let me take care of that for you.
Okay.
And then they're, they're,
they're full throttle after that.
They're not,
and and they ended up
becoming something becoming
a therapist becoming a
manager becoming you know
better than than what I
would have done if I if I
was telling them what to do
for for sure yeah
understood uh justin you're
right you're a baseball
player you ready to play a
game we're gonna play quick
game okay let's do it all
right we're gonna play play ball
or walk away.
Here's how it works.
I'm going to throw some
business moves at you.
You tell me if you're
swinging or if you're taking the pitch.
Swinging means you agree with it.
You take it.
Walking away, let it pass.
All right.
Someone opening a second
location before their first
one feels perfect.
I'm using that word in their
quotes specifically.
Opening a second location
before your first one is perfect.
Uh, I've,
I swing on that one already a few times.
So let's go ahead and swing
on that one for sure.
All right.
And why is it the word perfect?
Cause it, is it ever perfect?
Is that why you're going to swing?
That's one of my problems with it.
It's never, it's never perfect, but also,
um, it,
if it's part of your strategic plan,
which mine was, you know,
I wanted to open up three
locations within like the
first eight months in order to better,
um,
And I even had a plan that
included the names of
orthopedic groups and
physician groups in town
that I wanted to be their
go-to person for.
And so I was actually
reverse engineering that
and opening up locations
was one of the key components there.
So I had to open them up.
I had to put the cart before
the horse in order to get
that thing moving.
Hiring someone for culture fit,
even if they're slightly underqualified.
You swinging away or are you
taking that pitch?
Yeah, definitely swinging away there.
I mean, cultural fit or personality fit,
you know, I mean,
I think that's eighty
percent of of the
importance to to hiring somebody.
Obviously, they have to check a few boxes,
you know, like table stakes.
But but for sure,
I would definitely hire
somebody even if they
weren't experienced enough.
Two more.
Taking insurance contracts
just to fill a schedule early on.
Swing away or take that pitch?
Starting up DeNovo, maybe.
Maybe for like,
but I would be ready and
prepared to drop as soon as
I went on any kind of a waiting list.
The reasons why...
which we have dropped a few
of our bad contracts.
We've dropped probably over
fifty percent of them and
are and we were very happy
that we did that.
But the only reasons why I
would keep a contract in
the beginning is for brand building,
whether it's doing favors
for a specific orthopedic group.
And then once you get a
relationship with that
group or once you get a
relationship with that
that actual referral source, then you say,
look, dude, we know each other.
We're both business guys.
I got to drop
UnitedHealthcare because they
pay us fifty dollars per visit.
And at that point, you're like, oh, dude,
I can't believe you were
even taking them in the first place,
you know,
and that's an easy conversation to have.
But if I would if I would
have had that conversation
from day one de novo before
I even knew that provider,
it might have been the
difference between them
using us in the first the
first place so I'm not
saying that you have to
follow my path but as long
as you think it through and
have a strategic reason why
you're doing something what
I highly disagree with is
people just saying I want
to keep all my contracts
because I feel like that's
the right thing to do right
Last one,
offering cash-based services
inside an insurance-based clinic.
Swing away or take a pitch?
Swing away.
I guess I'm swinging on all
these questions here.
I like it.
Last thing we do on the show, Justin,
is what we call the parting shot.
Last chance for a mic drop moment,
soapbox statement.
What's Justin leaving with us at the end?
Let me think about this.
What I would say is
My number one thing that I
think has led to our
success is the ability to
take anything that comes at
you with an objective lens
and never worry about what happened.
I'll only worry about how
you fix it and how to keep
it from happening in the future.
And that's every decision that we make.
I don't dwell on things.
I don't get stuck.
And that includes hiring and
firing people.
I've hired people when we
didn't have a space for them.
And I fired people when I
couldn't afford to because they were,
because I didn't have,
but you gotta think
objectively and you gotta move on it.
And like,
you gotta be quick to make decisions,
man.
You gotta be quick.
Love it.
Justin, appreciate the time.
I don't want this to be the
last conversation.
I feel like you've got a lot
to teach people,
but I don't want to give
them all too much at once.
If someone wanted to reach
out and if someone wanted
to reach out and get in touch,
what's the best way?
I'm on LinkedIn.
I'd say that's the best way, you know, um,
you look me up there if, but I'm, I'm not,
I definitely don't hide all
my contact info, you know,
so you look me up.
I'm not, I'm not hard to reach.
Justin Siver.
Appreciate the time, man.
Thank you.
All right, Jimmy.
Thanks, man.
Good, good talking.