All right, first things first,
we got to pay for things.
If you run a physical therapy clinic,
you already know the front desk can get
overwhelmed fast.
Missed calls, scheduling changes,
patient questions, and it doesn't stop.
And that's a good thing unless you can't
handle those things.
That's where Sarah Health comes in.
Sarah helps PT clinics automate patient
communication,
things like appointment reminders,
follow-ups, common patient questions,
so your staff can focus on people instead
of phones.
Less administrative chaos,
better patient experience,
and get paid for that communication
between office visits.
Check them out at sarahhealth.com,
that's S-A-R-A health.com,
to see how clinics are simplifying their
operations.
Today's guest, well,
the traditional path in physical therapy
used to be pretty predictable.
Graduate, find a job, climb that ladder,
maybe become a clinic director one day.
But over the last, I don't know,
five to ten years,
something interesting is starting to
happen in this profession.
More PTs are asking a different question.
What if I built something instead?
Now, not twenty years into a career,
but right now, the old advice was wait,
wait, wait, then do it.
Now it's why not now?
And today's guest didn't follow that safe
path.
During the pandemic, after losing his job,
he started a PT business with less than
four thousand dollars in the bank.
I love stories like this.
The first clinic he built wasn't a clinic.
It was a basement.
We'll get into that.
Then a hot yoga studio,
then a space inside a local gyms.
Fast forward a few years and that small
experiment has turned into a multistate
performance therapy company,
a pediatric care brand,
a clinical education platform.
and a growing team of clinicians building
practices inside the model.
Today, we're talking about cash-based PT,
why more clinicians are starting
businesses earlier,
and why ownership might be the missing
ingredient behind burnout.
Let's welcome today's guest,
Nathan Lemaster.
Nathan, welcome to the show.
Hey, I appreciate you having me on, Jimmy.
A little hype intro there,
but I like being that.
That's sort of the point of the show,
which is like sort of the hype machine.
So take us back during the moment,
as I mentioned in the intro,
during the pandemic, when the world,
I mean,
it feels both five minutes ago and thirty
five years ago.
But when everything changed,
you lose your job.
You're looking at less than five grand in
the bank and you decide to push all
the chips in the middle, go all in,
start a clinic in your basement.
What was going through your mind?
Oh man, there's a,
there's a lot going through my mind.
I mean, uh, at my home, uh,
I was kind of the breadwinner being a
physical therapist.
My wife,
she owns her own photography practice as
well.
So it was something that during COVID,
not a lot of people wanted photos done.
Sure.
And I thought, you know,
this is as stable as it gets.
And then all of a sudden COVID hits
and then we start to see people being
furloughed and then only, um,
post-op clients are able to come in and
different things from there.
Where myself,
I'm very passionate about like direct
access clients.
So it was May twenty eight kind of
preface the situation.
I just had my second child two months
prior to that.
So Liam was born at that point.
And so as people are thinking, like,
how's this guy have less than five grand
in his account?
Well, you know,
we had a unexpected C-section.
And so with that,
we have medical bills coming in and we're
like, hey, you know what?
You pay them all up front.
You get a little bit of a discount
on that.
I think this is going to be better
later on.
So I ended up doing that.
And then sure enough,
May twenty eighth ended up being let go
from my job.
And the fun part about being let go
from your job is if you lose it
at the end of the month,
as of the thirty first of that month,
I actually lost our family's health
insurance as well.
And so we were we were in a
pretty tough spot.
And so I would definitely say that was
the time that was for sure the scariest
moment of my life and definitely
made everything a lot more vivid and you
still feel some of those things moving
forward.
But it honestly kind of helps you figure
out your why in the process when looking
to build your practice and what you wanted
to do.
Wow.
So the perfect storm, the imperfect storm.
It wasn't just one thing.
And it wasn't like it also wasn't just
happening to you.
It's not like you can reach out when
everybody else is going through a
pandemic.
Everybody's looking at each other going,
yeah, me too.
I'm losing this or I'm stuck or I
don't know what's going to be on.
There's uncertainty everywhere.
But you're the one who's being looked at,
right?
And then you lose one, two,
three things and you've got to figure some
things out.
So what was your next step?
What was the thought process?
Is it like, listen, Shawshank Redemption,
we either get busy living or get busy
dying.
No one's coming to help.
You decided to build something instead of
sort of wallow, it looks like.
Yeah,
and it was one of those things that
if a lot of students that come out
of school, right,
it's always student loan debt and
crippling student debt.
And at this point,
I was five years into the ten years
of student loan forgiveness.
So I was kind of like pinpoint in
the middle.
I was just like, all right,
so do I go work for another nonprofit
here that's not out?
Exactly.
and so that was kind of like one
of the scariest moments of it but with
my wife being an entrepreneur and her
family being an entrepreneur honestly they
kind of pressed me on that it's like
hey you need to consider this so at
that that point i actually had read uh
the book insurance from danny mata and i'm
sure people have talked to i mean he's
Brilliant the way that he does things.
And I have read that probably about seven,
eight times.
Put a little bit of a Midwestern spin
on it.
And I was like, you know what?
I think that I can do this.
So we actually took a small sabbatical
from Sioux Falls at that point.
I had gone out West River with my
wife.
That's where she's from, Belle Fourche,
Spearfish area.
and just kind of more so getting our
head right.
It was kind of down in the dumps
at that point,
but then one of the wins that came
through that is I got my letter that
said that I passed my SCS while we
were out there.
So I was like, okay,
I got the credentials.
It shows that I might be smart enough
in order to be able to do something
like this.
And then while we were out there,
I was like, you know what?
I think that I need to give this
a go.
So I actually called up one of the
local yoga CrossFit gyms out there,
and I was like, hey,
Do you mind if I come in?
I'll teach a course for you guys,
charge you absolutely nothing.
My only hope is that you give me
half a day at the gym just to
do treatments after that.
And so I had no idea what I
was doing.
I had an LLC that was initially
established just to be a content company,
just to kind of reach out to individuals
and blogs and different things from there
so I could run the business through there.
Had a massage table that I got off
of Amazon.
And then I was like, all right,
here we go.
So set it up in the CrossFit gym
after doing the course,
sparked enough interest.
And a couple of people were interested.
And I just remember the very first
treatment that I did,
I was charging a hundred bucks for the
treatment.
And I spent about fifty nine minutes and
thirty six seconds doing the treatment.
And then the remainder,
twenty four seconds trying to make the
pitch on like,
that'll be one hundred dollars.
Hope that they pay me.
Right.
I mean,
this is the definition of understanding
that with your degree,
it's the thing between your ears and what
you can do with that with your hands
or your mind and how you can...
This is all customer relations.
I mean,
this does not work unless you make someone
feel something in both the literal and the
figurative use of the word feel.
Everything was sort of riding on you.
So what happened next?
what you you were in a crossfit gym
you were you were essentially you were a
guest like you kept showing up to other
people's organizations and saying how can
i be helpful which if you listen to
someone like danny which i'm going to his
mastermind in just a couple weeks actually
um when you listen to someone like that
it's how can i be helpful like lead
with lead with a give and that seemed
to work how'd that progress
So the progression was, okay,
it panned out.
I ended up having four or five clients.
And so I made more money in an
afternoon than I had made in quite some
time.
So then after we finally got it all
together, moved back to Sioux Falls,
I'd been teaching at a hot yoga studio,
doing some fitness strength classes and
different things from there.
So I had worked out something with the
studio owner and I was just like, Hey,
is there any way that I can rent
this back room from you?
And I will,
I will teach here and I will keep
doing the things and give you as much
value as possible.
But through that,
I will also keep your members healthy.
I'll keep your members healthy because as
we know with
any gym membership,
one of the highest rates that people end
up canceling is because they're hurt.
And then they're like, yeah, no, I'm good.
I'm going to move on to the next
thing or go from there because this is
the thing that, yes,
it gave me joy and the endorphin release
and the mental space.
But then when they get hurt and they
lose that,
they want to go to the next thing
to prevent that from happening again.
So that was essentially the value that I
was trying to offer there.
And so
Uh, ended up working something out.
So then I was able to kind of
work out of this back room and progress
from there.
And I'd love to say that I had
the business brains behind us all,
but we went to school for physical
therapy.
We didn't have a lot of background.
So I actually brought on two small
investors in order to begin with where
they bought in for five percent,
gifted them three percent.
And it was just like,
I want them to actively be involved in
the company and teach me all of the
things that they know about business.
Because the number one thing that I've
realized,
if you're going to be an entrepreneur,
And something new,
you have to be coachable.
That's like the number one non-negotiable.
Sure.
Yeah.
You just look like you,
it sounds like in both of those
situations, you said, I know what I know,
and I can plug into this gym.
I know what I know.
And what I don't know,
and I can plug into this hot yoga
studio.
I know what I know and I know
it's more and I can go learn it
myself or the ultimate cheat code, man.
The story of my career and a lot
of people's career,
the ultimate cheat code is people and
bring them in.
And then that last part too,
don't just listen to them.
And this is from a guy who hosts
a podcast.
The listening is,
is a ten percent of it.
You got to go do it.
Listening is nice.
Doing is infinitely better.
A hundred percent.
So essentially it took a lot of their
advice and everything that I could started
to implement that.
And I, again,
I didn't know enough about business.
So it was like everything that I had
made,
it just stayed in the business because the
fear of failure is essentially the first
field to run on as an entrepreneur,
as I'm sure you know that.
And kind of you telling me the story
of you starting up the podcast and the
media side of things, it's just like,
Fear of failure.
It's a really, really powerful tool.
And it is something that heightens your
capacity and lets you shows you that you
can do a lot more than what you
actually think that you can.
So from there, it was just like, hey,
let's keep this money in the bank.
Let's keep it growing.
And I was lucky enough to look at
my past salary and then where I was
at at that point.
I was like,
I just need to see thirteen,
fourteen clients per week.
And at that point I can call it
breakeven.
And then eventually I started to kind of
progress past that.
And then I was like,
I think this might actually be a scalable
model.
So it was originally thought that
cash-based physical therapy wasn't going
to be that.
And so prior to me being let go
from my past position, I actually had,
I did a clinical down in Kansas City
and I had met my now business partner,
Tyler,
and he actually slid into my DMs and
he was trying to get back into the
Sioux Falls area.
And I actually called him up after I
was let go.
I was like, hey,
I got a job for you.
This place that I was at, they,
I mean, you can go work there.
They're looking for your same credentials,
your SCS and all the fancy stuff.
And I'm sure you'd be a great fit.
And he was like,
I'm not sure that I want to do
that.
And so kind of went radio silent until
this point in the business.
And I called him back up.
I was like, guy,
I got a crazy idea.
I want you to come work for me.
I'm going to pay you terribly.
But this is the vision that we're going
to believe in.
And there's potential for ownership if
this decides to take off.
So he actually ended up I started
technically June twenty eight.
Twenty twenty was when I saw my first
client.
Ended up hiring him September first of
that same year.
And yeah.
And so the reason that he was okay
working for me is I told him, hey,
I'm going to pay you forty five grand
a year.
And as most PTs know,
that's about half of what they typically
will make,
especially where he was at in this
position.
And I was like,
but if this takes off, I'm January first,
you hit X, Y, and Z,
then here comes the ownership side of
things.
And sure enough,
we kind of went from there.
So with me not paying myself and
committing to him and showing how much I
believed in him, then he's like,
all right, let's do this.
Wow.
So a couple of things, too,
I didn't want to skip.
I took notes.
Right.
Number one,
there's a psychological concept called the
sunk cost fallacy.
Are you that one?
No, no.
That's like, you know,
let's say you're halfway done going
through law school, but you know,
you hate it.
It's like, well,
I've already paid for half law school.
I might as well just keep going because...
So that's the concept.
You know you hate it.
You were halfway through loan forgiveness,
that tenure period, right?
And this wasn't by choice,
losing your job halfway through.
But you could have gone back and said,
well, I've already put five years in.
There's this other thing I sort of like
and it feels better.
Again, those jobs that are secure,
using air quotes,
aren't necessarily so secure, right?
I mean,
Jim Carrey is famous for saying that his
dad was funnier than him.
But because he had kids, he said,
I'm going to go take an office job
because it's safer.
And then his dad wound up getting fired.
So Jim Carrey's famous line is,
do the thing you love because you could
get fired from the job you hate anyway.
So the whole sunk cost fallacy stops a
lot of people.
Cause they're like, well, the safe thing.
I mean, Danny Matei, you brought him up.
He was a military PT.
I mean,
he could have just stayed right there.
Secure job and military guy, right?
You're, you're secured employment, man.
Military is not coming out of business
anytime soon, but he knew in his heart,
he was like, he tells the story.
I didn't like it.
And I wanted to change.
And Hey man,
we go around this thing a couple of
times and then we're dirt.
So you might as well be doing the
thing that you wanted to do.
All right, so Tyler comes on board.
What happens next to where you are now?
I mean,
I feel like there's a lot of,
I feel like the hockey stick on the
chart goes up.
When does that happen?
So then it came down to the very
non-traditional way of treating him.
As you said, like the, hey,
we like something, but we don't love it.
And that's kind of how I felt in
the last system.
It was just like I was being pigeonholed
to see post-op after post-op,
and I just wasn't passionate about it.
I was passionate about the individual that
was coming in with aches and pains or
something to prevent a surgery or
medication intake or anything from there.
And I felt like with the skills that
I had between the hands on manual therapy
training I had and then you throw into
that the ongoing increased research and
dry needling and the success that we've
seen with that.
And then the time of retention,
I was just like,
I think that there's more that we can
do here.
So we brought him down and his training
process.
Actually,
he brought over his sister in law at
the time.
And him and I,
we had a bottle of Jefferson Ocean,
and I taught him every single skill that
I knew under the sun.
And from there,
it was just like sink or swim.
At that point,
I had no experience managing people,
being a leader, or even really education.
So then at that point,
it was just like, hey,
this is what you have to do.
Now it's the relational side of things.
I had two to three gyms that I
was working with at that point.
I was like,
these gyms are off limits to you because
that is just compounding what we're
already doing.
But what I want is I want expansion.
And so I want you to go find
two to three other gyms because what we're
going to notice is more cash based
practices are coming.
And I want to be able to put
a chokehold on the roots.
Exactly.
The more gyms that we're in and the
more that we can find our active avatar
and going from there,
the better chance that we have at success.
So he went out there,
he had to hunt for three gyms himself.
He had average like two evals per week.
He had average,
I think like twelve to fifteen client
visits per week by December thirty first.
And then at that point he was able
to buy in for ten percent ownership in
which he was able to do.
Wow.
Okay.
So now let's do this.
Let's do that trick in the movies where
you jump.
Now we're going to just fast forward to
now.
What do things look like now as we
record in March of twenty twenty six?
Now things have definitely exploded
probably within the last year and a half
to two years.
So right now we're based out of Sioux
Falls.
That's where our central hub is at.
We have twenty three full time employees
and three part time individuals.
We're currently sitting in a forty seven
hundred square foot building that honestly
looks like a boutique gym.
We don't have any STEM units.
We don't have any ultrasounds units.
We don't have any traction tables.
We literally have turf.
We have squat racks, treadmills.
and then some insanely skilled therapists.
From there,
we have another office down in Omaha,
Nebraska,
where we have two physical therapists.
And then we have one down in Austin,
Texas,
where she just started just over a year
ago and she's absolutely crushing it.
So shout out to Mary on that.
And then we've also have a sister brand
called Move U that does pediatric
occupational therapy, physical therapy,
and
and speech that actually just started as
sensory based occupational therapy,
because we noticed that that was a very
underutilized area,
especially in the Sioux Falls area.
And they've been crushing it over there.
We got an insanely talented team.
It's based around our OT there,
whose name is Kristen.
Wow.
See a need, fill it,
and then people will embrace you and tell
their friends, hopefully,
and they'll show up.
the answer had to be people right from
you to you plus one to you to
now twenty plus in under six years
the answer has to be people.
I mean, obviously leadership,
but leadership is people.
What were some of the key culture
decisions?
These things do not happen by accident.
You don't accident yourself to where you
are.
You don't, right?
You just don't.
So what were some of the intentional
culture people decisions that you made
that allowed that kind of growth in such
a short time?
So the key for hiring Tyler was Tyler
was as close and similar to myself as
possible.
Being able to have somebody in case I
went down,
got injured or something like that,
that my clients could automatically be
close to and just kind of slide over
and be able to have somebody that they
trust and go from there.
Our hire after that was Mary,
who's now in Austin, Texas,
but she started here in Sioux Falls.
We wanted somebody that was completely
opposite of us.
I'm about six foot four.
She's about five foot three.
She's a runner.
I am not notoriously a runner by any
means.
She had passionate in the CrossFit world
and women's health.
And so we wanted to find something
to then expand even further not just
expand to the next gym but also the
services and the type of avatar that
people could connect with and honestly
that's something that we chase moving
forward is finding individuals that are
passionate about a certain area it's not
doesn't have to be a specific area that
we're hunting for just be passionate about
it we've got a guy on our team
that loves treating wrestlers he was a
college wrestler and we saw almost no
wrestlers prior to him coming here and now
his schedule is probably about sixty
seventy percent wrestlers we got
Uh, one of the arguably,
one of the best run I've ever seen
and what we've noticed with all these
individuals is they're all high achievers.
They're insanely coachable and they're
bought it.
They understand what we're trying to do
and move forward,
but they also understand that we provide
harmony.
So we always say that we don't believe
in balance balance is bullshit because.
there there's no even keel there it's
always hey sometimes life is going to need
more sometimes the business is going to
need more and so we try to get
ahead of that by making sure like all
of our pts maximum they're seeing is
between
Thirty three clients to thirty five
clients per week.
And then on top of that,
we provide them with your traditional days
off that you have for holidays and all
those things.
But we also provide their birthdays off
spouses, birthday, kids, birthdays,
anniversary.
And those are things that are just built
in the package.
And then we also say thank you.
One more step by paying for one hundred
percent health insurance for.
Sounds like you reverse engineered what
you were looking for.
Yeah, all the frustrations that I had.
And it's kind of funny that you said
that because I designed this document of
different frustrations of my past job that
I wanted to implement to help their
company out.
And I just kept getting slapped on the
wrist and told to be quiet.
And then next thing you know,
I'm using that as my business startup
document.
that's your North star.
I mean, that's what you're doing, right?
Like we get, again,
we get one go around, man.
And if you're saying, I wish, I wish,
I wish, but you literally,
like some people would say, it's just,
you know,
think about what you want and create it.
You quite literally wrote it down.
Yes.
Did that help when it made it,
when you wrote it down?
Did it, what did it do?
Honestly,
it highlighted how much in a big system,
things like you can tell one person,
but then it's like the telephone game.
They have to tell the next person.
Where you start something small,
I can make a change immediately.
And then all of a sudden,
that ripple effect is felt right then and
there.
And so I also just wanted to make
that feel like no matter how big that
we get in certain locations,
I always want that small feel because I
want that experience.
I want individuals to know that they can
Shoot us a text if something's going
wrong.
Give us a call if they need an
emergency visit on a weekend.
But at the same time,
be able to make connections like this on
a much larger scale than what we're used
to just to be able to connect and
just kind of show like this is still
a part of who we are,
the DNA of what we're trying to create.
Yeah.
It sounds like instead of becoming a giant
aircraft carrier,
you became a group of speedboats.
But when you're together,
because each of them has autonomy,
each of them has the area that they
like and have.
Well, you want to treat wrestlers, man,
help me find the wrestlers and you could
treat a hundred percent wrestlers,
but show me how to do that.
We can work together instead of I demand
this and then you have to work.
It's you're meeting them more than in the
middle.
Absolutely.
And everything's a conversation.
And I think that's something that's really
good is between the coaching either my
team gets with myself or with Tyler or
anything and putting in the right people
in the right seats.
We run our business through what's called
Traction by Gina Wickman.
Fantastic book.
And honestly,
first time I read it starting up my
business,
all of it was completely over my head.
But our investors at that time was like,
this is the way that you need to
do it.
And even now to this date where both
of those investors are
bought out and gone it's also one of
those things that's just like that was so
valuable what they gave us is telling us
like have the hard conversations have
systems in place have the right people in
the right seat that have the uh get
it want a capacity to do it and
then from there the business will take
care of itself yeah do the small things
and the biz the big things magic magically
happen right it sounds like you knocked
over the small dominoes first and then
when you knock over the small ones the
bigger ones will follow
You said something interesting too.
Burnout isn't always about volume.
Sometimes it's about ownership,
personal business.
I mean,
ownership can have a lot of words.
Help me understand.
Burnout isn't always about volume.
Sometimes it's about ownership.
Yeah.
So, uh, I'll even talk to, uh,
about kind of my own personal path and
just like at the previous jobs,
like I was not passionate about treating
post-ops and like,
doesn't mean I wasn't good at it.
Doesn't mean that I wasn't capable of
doing it,
but it was one of those things that's
just like another total knee,
another total hip.
And it was.
kind of the ongoing repetition and it was
just like, okay,
so the surgery goes well and the PT
goes well,
all of a sudden the MD gets a
shout out.
But if PT starts going off track,
then it's time for them to find another
PT or the client would come in
and think that this surgery was going to
automatically turn up their lifestyle and
their activity level.
And it wasn't always the case.
And just like seeing that up and downs
of disappointment and going from there.
And so I tried to get so much
continued education to pigeonhole that I
would just be seeing sports and
performance and going from there.
But then I realized it was just a
ladder game and I needed to wait until
the next year or two years or that
person retires or this person's gone in
order to move up from there.
And then even in terms of other burnout,
it's just like sometimes it was just like,
how many units can you charge during this
time?
How many individuals can you bring in and
pump out at the same time while still
creating decent care?
And a lot of times when that would
show up,
a lot of these individuals would just say,
you know what,
I'm not passionate about this,
but I'm here for my eight to five
paycheck.
And then after that, I'm done.
And there was no harmony to that.
The balance was the start and end of
the job.
versus allowing for listening to clients
that might need a treatment on a weekend
or a weeknight or something like that in
order to work with them.
But then you don't mind it because it's
somebody that you want to treat,
that you're passionate about,
that you become friends with over time,
but still able to remain the professional
in the room to keep them carrying on.
And I've noticed that when you have the
autonomy,
whether
the ownership in a company that you truly
care in every single session especially in
the cash based world has to be a
hundred percent dialed in because these
people are coming in to pay their cold
hard cash so the experience has to be
spot on the treatment has to be spot
on and the value has to be there
but then to take that a step further
being employed within a cash based company
is giving them the autonomy to see who
they want and empowering them with that
that next level and that next ability to
say all right you want that i will
lay out the path for you you chase
it create the job that you want
Yeah.
You've got it.
If this is what you want,
I can help you build it.
But we sounds like you're creating a group
of builders.
Absolutely.
I'm always into hiring the right person,
even if it happens to be the wrong
time.
Very gut instinct.
My business partner, Tyler,
he's way more analytical on that.
I'm way more gut instinct.
This is who I think we need to
hire next.
They're fantastic.
Let's stock them until they want to come
on board.
You got a good person.
We'll figure out where to put them.
Don't worry about it.
The hard part is the diamond.
We'll figure out what to do with the
diamond if you've got one sitting in front
of you.
I want to say thanks to our friends
at Empower, keeping the show on the air.
Documentation shouldn't be the hardest
part of your day.
And if it is...
You can change it.
It sucks changing an EMR,
but I'm telling you the juice is typically
worth a squeeze.
Empower EMR was built specifically for
rehab therapy practices designed to match
how PTs actually work.
Simple workflows, clean documentation,
and tools that make it easier to stay
compliant without slowing you down.
It's always frustrating.
So if you're evaluating EMRs or just
fighting with your current system,
take a look.
at Empower EMR.
I know the change can be hectic.
I understand that.
But otherwise,
you're going to use it every day.
It's like it's sand in your bathing suits,
my friend.
So just take a look.
Built for PTs, not accountants.
Learn more at EmpowerEMR.com.
That is Empower EMR.
Cash-based physical therapy still feels
intimidating for a lot of clinicians.
Again,
I mentioned I'm going down to one of
Danny Maté's masterminds.
Essentially,
it's just a group of people who are
somewhere in the process with him and his
group of doing it.
What misconceptions?
Most of the time when people think
something is hard or scary or impossible,
it's a misconception and the funny part is
once you get past that you turn around
you look at it you're like that's what
was holding me back that's what i was
afraid of so what misconceptions do you
see most often when people are like oh
i could never do that or that wouldn't
work here you're in south dakota man
Price tag and demographics.
For sure the price tag.
So every time that I go to Briarcliff
University or University of South Dakota
and I teach a little portion of the
business side,
one of the first questions I ask is,
how much do you think it costs for
me to start up my own practice?
And you get wild numbers.
I think the highest I've ever heard was
over a million.
And some people are seven hundred fifty
thousand, three hundred thousand,
two hundred thousand.
When I told them that I started up
this whole business for less than four
grand, they're like, are you serious?
I was like, yeah,
the cheaper materials in terms of a
massage table,
you need to be really highly skilled.
Hopefully you have that prior to going
into it.
But then on top of that,
dry needles was probably my highest cost.
I mean,
I almost didn't start the company because
of two hundred dollars worth of foam
rollers.
And it was just like it's just like
where you're at at that point in time
and realizing it doesn't take that much.
What it does take is the sweat equity.
The sweat equity and the grit that goes
with it, quite frankly,
for the first two years of starting a
company, you got to be a yes man.
You're a yes woman.
And you got to say yes to all
these different things going on because
you need that brand exposure.
You got to let people know that you're
there where these other companies can pay
the money to put it up on the
billboard that I can't afford.
But you know what?
I'm right here.
I'm in your face.
And I'm willing to have that conversation
and provide as much value with you as
possible.
Yeah.
It's funny.
You get...
real crafty.
And then later on,
when you do have the forty thousand square
foot facility,
you sort of hopefully you regain that you
retain that sort of gritty mentality.
I'll give you an example.
The radio station that I want to finish
in my career with started off as sort
of like
the third stepchild in the market.
There were four radio stations in one
building, but then, you know,
there's fifteen other radio stations in
the market.
And nobody's going to put money into the
third best rock station in an area.
So my boss and I looked at me,
I'm like, he's like, I'm like, well,
we need billboards and we need you guys.
I don't care what we need.
We're getting it.
So he taught me to look at what
do we got?
He's like, well,
we've got a van with a big logo
on it.
They'll give us as much gas as we
want.
We've got a gas card.
And then we've got a Xerox machine.
We've got a copier and as much paper
as we want.
So we drove around and we'd make funny
posters, almost like band posters.
These were memes before memes were memes.
And we would drive around and we'd go
to TGI Fridays and we'd just put them
under windshield wipers.
And there's no way to measure that ROI
properly.
at all especially in radio especially back
then but you just you you you i
think it was eisenhower said you don't go
to war with what you need you go
to war with what you have so amen
i got two hands and i got a
table all right like what can i do
with this and the funny part is i
still act like that
Which is, well,
now we have some more resources.
I go, yeah, yeah, yeah.
But are we just using it because we
have it?
Or is it the best option?
Is the best option to be a little
MacGyver-y or be a little,
you're dropped on a desert island,
figure it out-y.
And you get some really interesting,
that's how you differentiate because you
get some really different solutions that
most people don't see.
A hundred percent.
And taking that from,
and I think that's why this company is
just like so special is because
it does have that grassroots mentality.
And there was plenty of times like
weekends and different things that you're
saying yes to that typically you wouldn't.
There's several times that I'd show up to
people's houses for a home call at seven
thirty p.m.
at night.
And it was like cutting in.
But at the same time,
it was the best exposure that I had.
And a few of those things is and
one of the things that I coach on
now is just like, hey,
what is your what is your current small
bubble that you're just comfortable in and
how do you push that capacity to get
more?
Because quite frankly,
like I hate being on social media.
But at the time, especially during COVID,
it was one of those things that a
lot of people were like, hey, yeah,
I'm stuck at home.
Let's check out what's going on.
So putting up workouts,
putting up social media posts,
then putting yourself out there.
And some people absolutely loved it.
Other people didn't like it,
but we've realized that we're not for
everybody.
Then once you start to get okay with
that feeling that you're not for everybody
or that the worst that somebody can
actually tell you is no,
then you just move on to the next
one and you provide values to the ones
that want it.
That's what's pretty cool about the whole
process.
Yeah.
If I could hack someone's brain,
it would be that sort of fear of...
It's not even fear of failure.
It's fear of the embarrassment from the
failure.
You failing...
And this is a buddy of mine who's
a psychologist.
He's like,
the difference between shame and guilt
is...
uh shame is you feel like you've done
a bad thing and guilt is you feel
like you are a bad person and i
was like oh wow i used to use
those words interchangeably so there's a
parallel there which is like someone
saying no isn't saying anything about you
it's saying they don't need that you're
not bad right so i think that that
probably held
uh holds a lot of people back myself
included which is what if they say no
what does that say about me we're not
talking about you this isn't about you
they didn't say no to you they said
no to the thing you were offering for
whatever reason ask fifty more i mean
there's a great uh professor i think he's
at duke or unc
um his whole class is about failure where
he teaches you a hundred ways to fail
but the thing is a hundred along that
way you understand how to be successful i
mean i had jobs back in the day
where i had to make phone calls for
a university and uh the guy in charge
gave us a deal he said if you
get ten no's in a row you can
take an hour break
How fast do you think we made those
ten calls?
But he goes, if you get one yes,
if the ninth call is a yes,
your counter goes back to zero.
But it put it in a different mindset,
which what if I'm trying to get the,
what if it's just like,
now it's a game.
All right, let's have some fun with this.
And it changes your attitude,
and that's sort of the point.
Absolutely.
And that that fear of failure and kind
of going through that process, man,
it's I actually had to go through my
own business coaching because I realized
that I was going through and I was
creating stories in my head.
And it was just like this person said
no,
because maybe they had a bad experience.
And then now they're these other people
are coming in because they talk to those
other people.
And then I realized that it was just
like I was self catastrophizing.
And how much headspace was I actually
wasting where I could have been putting it
towards something more productive?
Yep.
We are the cause of,
but solution to our own problems.
We have to be, right?
A hundred percent.
Failure is the best thing that could have
happened to us.
Like you strike out one, two, three times,
but then it makes you look at the
next pitch just a little bit different.
And you start to think, okay,
I made the decision here.
How can I make the small corrective action
to go forward?
Because it's not about a good decision or
a bad decision.
It's about, hey, I made the decision.
Now what's the next thing that I can
do to correct it the way that I
want or keep it accelerating at the rate
that we're going?
Yeah.
What's the next best thing?
So move you is very different than empower
you.
What have you learned about their
different businesses?
They might seem similar,
but eventually they're going to teach you
different things.
What are some things that you've learned
about those different models that have
taught you or guided the other?
Like one thing, if you're learning,
it's teaching you on both ends,
but what are some of the things that
you didn't expect?
I love similarities and differences.
That's why I love this too.
Sadly,
it took us like up until just last
year, like this business is about three,
three and a half years old,
but it wasn't until a year ago that
we realized that we couldn't just treat
cash based physical therapy the same as
cash based occupational therapy,
because that's what it was at the time
of the genesis.
And for so long, it was like, hey,
yeah, we can do this.
We just implemented and empower you.
Now we're going to do the same thing
and move you.
But then we started that noticing like a
lot of these kiddos actually needed care
longer than what we could originally
offer.
And then those price tags add up and
that's just definitely something you have
to consider.
So it wasn't until Q three for sure,
where we started having more discussions
about like,
how do we help more of these kiddos
for a longer period of time?
Because cash base,
we have the Google reviews,
we have the experience,
we have the rock climbing wall,
the trampoline, the rainbow room,
we have all this stuff to make it
an incredible experience where it doesn't
even feel like treatment for these kiddos,
but it's more felt by the parents.
So then we started thinking that Empower
You is going to be more your, hey,
yeah, you can feel it in one session.
And then that's our buy in our pre
and our post test.
But over at Move You,
it's much more of an emotional brand.
So we had to put ourselves in the
shoes of these parents and my kids have
gone there as well.
and seeing like, okay,
maybe it doesn't need to be a hundred
percent cash base.
So it started as a hundred percent cash
base and it wasn't until Q one of
this year did we actually move it to
a hybrid?
So it's a cash led hybrid where we're
only taking one insurance provider and we
went from seeing like
Forty to forty five visits treatment week
between two OTs,
one speech therapist and one PT.
Now we're cooking at like ninety plus per
week because now more people are coming in
that are talking more about the brand and
all the individuals that are coming in
aren't just insurance based.
They're just talking about the experience
and the success that they're seeing in
their kiddos with what move you can offer.
And then now they're starting to tell
other people and more people are starting
to gravitate towards it.
That's a big,
sometimes hard lesson to learn,
which is sometimes you have to look at
yourself and go,
what do I need to change?
I mean, you can wish,
you could yell at the tide all day.
It's still gonna come in tomorrow.
If you can go get a broom,
it's just gonna come in.
But yeah,
sometimes there's that thing is why don't
people get this?
Um, people are stupid.
Their attention spans are short.
They don't see value.
And you have to stop and be like,
how am I showing it?
In what ways?
How do I improve it?
Cause,
cause wanting them to change or that
doesn't, that doesn't cause the change.
You are the thing that you can control,
focus on the things that you can control.
And then magically success follows just
after that.
Absolutely.
So Q four of last year was when
we started to have to make like a
lot of
hard decisions hard decision is being at
first like yeah we're never taking
insurance but then leaning into the fact
like yeah this is actually just better for
the clientele that's over there it's
better for the families and this is how
we help more individuals then we're
essentially making no profit q three and q
four to actually turning a profit now now
we can reinvest back into our team and
then we start to get better raises we
can start to improve the facility a little
bit more and we've actually started
talking about what does move you look like
in another community
Yeah, now you can look downfield.
You're being pro and not just reactive.
Now you're mentoring clinicians who want
to start practices themselves in many
ways, shapes, and forms.
What mistakes do you see young PT
entrepreneurs or OT entrepreneurs or
speech therapist entrepreneurs,
what kind of mistakes do you see them
making early?
And this isn't to call them out.
This is pattern recognition, right?
If you can spot the common mistakes
we can educate to alleviate this.
So what are some of the common mistakes
you seeing entrepreneurs making?
I would definitely say that a lot of
these individuals,
they ride the high highs,
but then they hit the oh shit button
way too soon.
And a lot of that is because when
you're a solopreneur,
especially in the cash-based world,
and definitely starting out, it's like,
hey, new evaluation, new client comes in,
and then all of a sudden you see
a spike in revenue.
But then most of the time,
whether they're not selling a package plan
or anything like that,
then they're kind of ups and down all
over the place.
And then during their downs, they're like,
oh man, I'm not feeling good.
I don't know what to do.
Well, most of the times,
because they didn't leave the money
setting into their company to reinvest
into it or to make it through those
kind of thinner months,
especially starting out.
And I'd probably say that was that is
one of the biggest mistakes.
And then secondly,
is not being involved enough in the
community.
Too many times they'll start off what
they're doing and think that their
Instagram or their Facebook should pop off
based on the support.
But honestly,
the people that are yelling from the
nickel bleachers at first are people that
are actually just your friends and family,
and they're not actually willing to come
in to see you.
They're the ones, yeah, cheering you on,
but they're not the ideal clientele.
So at first it feels like this big
hype.
Congratulations.
Moving from there.
And then all of a sudden you get
crickets on the back end.
But those crickets are going to keep going
unless you go out there and you start
to get involved in the community.
You start to put yourself out there,
get outside of your comfort zone and show
them like, hey,
this is the value that I can offer.
And quite frankly, do it for free,
do it for cheap so that people can
understand who you are and go from there.
Yeah.
Show, don't tell.
Listen, views and likes,
they are a beauty pageant metric, right?
It feels... Listen, it is what it is.
It's a dopamine hit.
Can it lead to things?
Absolutely.
But people connect with who they connect
with, right?
So is it all one thing or don't
do any meat?
No.
The answer is probably a little bit of
both.
And the funny part is when you show
up to connect...
that's uh it's a high commitment low cost
right like I was I was talking with
someone every day who was like we started
a running group and I said how many
people did you start with and they said
two it was it was my it was
my uncle me and my uncle and I
said what'd you do and they said we
we shot a bunch of pictures and talked
about how cool it was and the next
week there was one extra person I was
like I gotta be honest man uh that's
a thirty three percent increase that's
pretty good
What are you going to do about next
week?
How do you get one next week?
Everybody wants to start on third base.
I get it.
Everybody wants to start off with forty
thousand square feet and turf and a rock
climbing wall.
All right.
You can take out the loan,
but you still now you don't have the
experience and how to fill it.
Yes.
Right.
Everybody wants to start, you know,
born on third base,
thought I hit a triple.
Earn it like be gritty, be MacGyver.
Like, you know,
do you have to be the best teacher
is uncomfortableness and failure.
Yeah.
Man, I love that third base analogy.
I think that is a great,
great just like gut check.
And especially as people are going out
because, I mean,
you got to see the pitches coming in.
You got to be able to get there,
whether it's going to be a bump,
whether it's going to be a single.
You got to take each win as each
win.
You got to know like, hey, yeah,
these are things that working.
And you know what?
Sometimes what don't work,
it's still an experience that you're
gaining and something that you can use
moving forward to continue to move your
business forward.
Yep, yep.
You learn something and that's a whole
idea around stoicism, which is like,
instead of why is this happening to me,
what is this teaching me?
And trust me, man,
when you just got your ass kicked by
life,
you don't want someone leaning in your ear
going, what did you learn from this?
You don't want that.
And that's why I usually give a twenty
four hour grace period.
I can bitch about something for twenty
four hours and then I what is it
out?
Are you done?
What are we going to do about it?
Life doesn't care.
It does not care.
So we need to fix it.
All right, let's play a quick game.
Startup reality check.
Three fast scenarios.
Just answer whatever it is.
I hand you two thousand dollars in the
treatment table tomorrow.
Where are you going?
What's what's what's in your first day?
What are you doing?
Where are you going to?
You got two grand on a treatment table.
What do you do?
Two grand.
Honestly,
I'm probably holding on to the two grand
in order to make it through the days.
And I've taken my treatment table and I'm
probably going to two to three different
gyms in that day.
And I'm going to the top person in
that gym, whether it's the owner,
whether it is one of their top trainers.
And I'm demonstrating to that person in a
free session what it is I can do.
I'm using that two grand to elongate my
business as much as possible until people
realize the value that I have for them.
Yep.
Yeah.
Money is a tool.
You don't always have to use it, though.
You can hold that, right?
Until you find something, right?
Until you're like, okay,
this is something to invest in.
Scenario two.
What's one thing new clinic owners obsess
about that actually doesn't matter early?
A thing that they obsess about that
doesn't actually matter early?
I think that we kind of hit it
earlier is social media,
like social media.
They want it to look all just like
perfect and pretty and all that other
stuff.
But people relate to grit like that.
What does your day look like in different
things like that?
What are the struggles that you're going
through?
It doesn't have to look perfect by putting
the different things out there.
Just put content up,
relate to people and people will find you
as long as you're out in the community
and then be able to relate to you
that much more.
Be real.
Third scenario,
one decision that matters way more than
people think when building a practice.
I feel like I could answer for you,
but I want to hear your answer.
So a decision that matters way more than
people think when building a practice.
Honestly, finding a good coach,
finding a good coach,
because that is something that it can take
away a lot of the bumps and bruises
that you're going to feel along the way.
And then the second side of that is
if you're going to choose to have a
business partner,
you got to date him for a long
time.
You got to make sure that they are
the right person because divorces are
ugly.
And this is somebody that you're into a
business marriage with.
And quite frankly,
it can be just as hard as a
real life divorce sometimes.
I'll throw in an answer for you,
which is don't always rely on analytics
when you're judging a person, right?
Love that.
Yes.
I mean,
I was more of a fit person than
a, well, that person's resume is.
And I'm like, I don't know, man,
I got to hang out with this person.
And I feel like that person gets it
right now.
Give me the personality with a little
mental agility and that's going to go a
long way.
And we'll teach if you can be coachable.
I mean, that's a skill, right?
Being coachable.
All right.
Parting shot.
This is The Parting Shot.
One last mic drop moment.
No pressure.
Just your legacy on the line.
A quick thank you to U.S.
Physical Therapy for supporting the show.
USPH partners with clinic owners and
leaders across the country to help
practices grow while maintaining strong
clinic culture and operational support.
They've built one of the largest networks
of outpatient physical therapy clinics in
the U.S.,
and most of the time you don't even
know because the brands stay their own
brands.
It's really kind of wild.
So if you're a clinic owner thinking about
the future of your practice, growth,
partnership, or success,
learn more at USPH.com.
That is USPH.com.
All right,
so if a PT listening right now feels
stuck in what we'll call a traditional
job, nothing wrong with that,
but if they have an idea for something
different,
what would you want them to know before
they take that leap?
What's Nathan whispering in the ear?
I would say clarity usually follows
courage.
Most of the things that changed my life
didn't start with certainty.
They started with a decision.
just being able to pull the trigger on
that decision and then you just see what
life throws at you at that point clarity
follows courage and motion uh creates
emotion like you got to move first guys
listen this is coming from a guy who
hosts a podcast it's great to listen but
go do you got to do listen all
right you could do that or even better
hey man podcasts are portable listen while
you do listen take us in the in
your in your headphones and listen while
you do hey if somebody wants to connect
where do you want to send them what's
the website
Go check out TheEmpowerU.com.
You can check us out at EmpowerU
underscore SD on Instagram or check us out
at TheEmpowerU on Facebook.
We'd love to connect.
Biggest ask,
but just let's have a conversation.
Perfect.
Appreciate the time.
Thanks for telling the story.
Thanks for doing what you do.
And I don't know, man,
I feel like we check in in a
year or two.
We're going to have a lot more to
talk about.
I would very much welcome that
opportunity.
I appreciate you having me on the podcast.
Love the podcast.
Love everything that you're doing, Jimmy.
Thanks, man.
That's it for this one,
but we're just getting warmed up.
Smash follow, send it to a friend,
or crank up the next episode.
Want to go deeper?
Hit us at pgpinecast.com or find us on
YouTube and socials at pgpinecast.
And legally, none of this was advice.
It's for entertainment purposes only.
See, Keith?
We read the script.
Happy now?