A lot of people want to get started in a cash-based physical therapy clinic. Sure, you probably need to be an expert at something, with a solid niche, to make it a little easier to get started.
But to be really successful, it comes down to customer service and realizing this is a service-based business.
Here are some keys to our success at Champion.
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#AskMikeReinold Episode 307: How to Build a Successful Cash-Based PT Practice
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Show Notes
How to Prepare to Transition to a Cash-Based Physical Therapy Practice
Transcript
Chris Clary:
All right, so this question is from Corey from Santa Clarita. He says, “What are the essential elements that go into building a successful cash-based PT clinic like Champion PT and performance? Not the specific state or state requirements for starting your own business, but what strategies should I focus on and utilize that will help me grow my business and make it prosperous?”
Dave Tilley:
I love that. I want that drawl in there next week everybody. I’m just going to say for the record.
Mike Reinold:
Yeah, good job, Chris. Oh, there’ll be others. There’ll be others, Dave. There’s always more. Great job, Chris, that was awesome. Good question here from Corey. I like this and I like how he is not asking about the details of getting your license and stuff like that, but how do you make it successful? Not just open up a clinic, but make it successful. I think, Lenny, I’ll start quickly with Lenny and I’s strategy. The first thing we did was, it was a little bit hard to find, but we got smoke and we had this and we had it for a while and we were thinking what are we going to do with this? And then we found a mirror, and then we put smoke and mirrors together and that is when Champion exploded. You guys were like “where am I going with that?” My 9-year-old would crack up at that one.
But anyway, I think this is a good perspective. Why don’t we start with this because I think this is almost a question you have to reflect on a little bit, but each of the therapists here that work for us, I mean you could argue, has their own mini cash-based practice, right? Because you still have to serve your clientele. We’re a very service-based industry. I think our coaches in the gym are the same as well. Very service-based with things that they do. So I don’t know, Len, maybe from the business standpoint, what were some of the keys that you think we talked about? Maybe you and I would go back and forth on this, and then I’d love to hear from the PTs to say maybe the one or two things that they think transition them from an insurance-based model to here. What were some of the things that were successful? But Len, you want to start?
Lenny Macrina:
Sure. I think, in my memories, I probably should have a diary of all this at some point and write a book, but boy could I write a book with my 20 years of experience as a PT. Anyway, I think it goes back to, we talked a lot when I was in Birmingham and you had left the Red Sox, and you going to that gym in Needham at Pure Performance and just kind of running a beta cash-based practice, you by yourself with a massage table, and it just took off, just you were crushing it, and we were like, I think we can pull this off. If you build it, they will come. I think if you’re a good person, you got some personality, you treat people well, you’re there for people, you answer their text messages and email queries, and you are trying to help them and you facilitate things for them, getting to doctors and giving honest opinions on what’s going on with them, and they can see through the BS, and if you are honest with them and treat them well.
And you started it with Pure Performance, having that little cash-based table. And then I came up and said, we said, I don’t know, I’ll quit my job and we’ll figure this out. And, then my schedule is busy, I mean days later. And, I think that’s been a trend with everybody who’s come on. We were always worried “will we be able to fulfill the PT’s schedules?” And, then it just catches on. And then if you bring in good people. We have amazing people that are there for their patients and their clients, and people see that and refer their families and friends, and it just carries on and on and on. So, I think just having a plan, seeing what the market is, seeing what the rates are, not being too aggressive with your rates and keeping it simple. Keeping it clean. We had a few tables. I think you went to, a PT went out of business in Rhode Island, if I recall. And I went down and bought a hydrocollator and random stuff, and you stored it in your garage for a while.
Mike Reinold:
Yeah. Connecticut. I forgot about that. Yeah, yeah, we got a U-Haul truck. It was in my garage for a solid year. I forgot about that.
Lenny Macrina:
Yeah. If you think about some of the stories of this person who was running a going out of business sale, and we took advantage of that, that’s still a hydrocollator, I believe. So little things like that, start small and develop your niche in the community and hopefully you have connections in the community where you’ve already been practicing for a while so people know you because they’re going to follow you. And it just took off after that.
Mike Reinold:
It’s funny that all the students still keep coming and saying, so we are always asking, so what do you want to do? What’s your dream stuff? And they’re like, “Oh, I want to do exactly what you’re doing.” I’m like great. Next year? Or do you want to take 25 years to get there? I don’t know if they realize that. So it’s actually funny you share that. Because I don’t know if we’ve ever talked about some of those silly little things just behind the scenes, but we’re talking about two established, well-known physical therapists in the world that were squirreling away Keiser machines that we’re getting from Craigslist in my garage. I still have crap in my attic that we never use, to be honest. I should probably go through my attic, right? But, everyone thinks the path to success was simple and easy and quick, even for somebody that’s experienced.
So, that’s actually a good humbling way to think of it. I would say what I would take, the two things I would take from this, from you, Len, that “how do you have a successful practice?” I would say that we were experts in something. Not everything. We’re not amazing. We’re not the best at everything. We’re not the best physical therapists in the world, but we were experts at something. So, we had a strong niche, a strong passion. And I think in a service-based industry that helps a ton because it just helps with everything. Communication, marketing, you can just talk the talk. I think that part is really, really interesting. But, I think the other thing sometimes you and I take for granted is that our attention to detail and service is something that I think not a lot of people understand. And I don’t know about the current generation. Things are different.
We’re more than two decades out now, so we’re freaking old Len. But service is interesting. I cannot tell you in the last week how many people, how many clients, current and past, that I’ve been texting with and talking to and doing things with. When somebody texts you at 9:00 PM you don’t say like, it’s not during my work hours. I don’t want to give my personal cell phone. I mean it’s service, right? And we’re there to serve. And that’s what has these repeat people over time is that we dedicate ourselves to those people because we enjoy it. We like doing it.
And we were taught that. We were taught that by Kevin Wilk. We were taught that by Dr. James Andrews. He’s probably one of the most successful, hardworking people out there. And they’re some of the best, but they’re also some of the more accessible people in the service-based industry. So, I like that, Len. And I would say those are probably the two things that I think you and I would probably credit the most. But I’d love to hear from the other guys. If you each had one, maybe Dave, Dan, Kevin, and Mike, start with you guys. But what’s the one thing that you think that you do that makes you successful at this cash-based business? Dan?
Dan Pope:
God, there’s a lot with this one, right?
Mike Reinold:
I know. One’s not fair.
Dan Pope:
Yeah, it’s okay. I think one of the big things, and we tend not to think, as entrepreneurs or business people as physical therapists, but we essentially solve problems. And that’s kind of business 101. If toilet paper is something that solved the really big problem, people buy it. I think that as physical therapists, we have to think about this a little bit, too. In the typical market, we have a lot of folks that don’t have the best care because they want to get back to higher level sports. Insurance doesn’t cover that.
So, I think the problem that we solve for the consumer is basically they want to get back to something that’s higher level, and they can’t do it with a standard model. And we’re actually there for that. So I’m a big guy of pick your niche, go deep in that, build a community, all that stuff. But I think that what you have to ask yourself first is that, are you solving a problem that needs to be solved, right? Because if you don’t have something that solves a problem, you don’t really have a business, and you might just be ramming something down people’s throats they don’t really want or need. So, I think that you probably need to start with that and figure out if you’re actually helping folks from that perspective.
Mike Reinold:
I like it. I like what you said right there, too. We all believe in the niche, and I think we always think of the niche as the type of person we want to work with, but I like how you rephrased that a little bit or reframed it almost as a niche in the market need. So, the gap isn’t necessarily working with fitness athletes; it’s getting them from acute to return to the gym. That’s the gap. And I think that’s a great way to think of it. I think that’s what cash-based does for a lot of people without insurance restrictions is it allows you to do that. So, that’s a good one. I think we can both argue whether toilet paper really solved that problem or not. I think it made it worse, but that’s a whole other conversation. But I don’t know, I think I saw Mike first. What do you think, Mike?
Mike Scaduto:
Yeah, I think I have been at Champion for a few years now. I think one of the biggest things that we all try and do is really excel at the communication with the clients. And oftentimes, I think clients, patients come to us, and a lot of times it’s a second opinion. They’ve been to an orthopedic surgeon, they’ve been to other physical therapists, and they didn’t necessarily get the answers that they want, or they weren’t satisfied with the diagnosis or the treatment plan. And I think where we kind of excel is trying to communicate what our plan is, how we’re going to get you to where you want to be, and then also if we need to pivot and change your treatment plan, I think we excel at kind of communicating how and why we’re going to do that. I think that’s a big reason why patients keep coming back for repeat injuries in the future. If they get hurt down the line, we’re the first people they call because they know that we can communicate with them about what’s going on and how we’re going to work to fix it.
Mike Reinold:
I like that. That’s a great example too, Mike. Perfect. Yeah. Kev, what do you think?
Kevin Coughlin:
Yeah, so just as someone that’s joined the staff a little later than some of you other guys, I think where you guys have mentioned the niche a lot makes a ton of sense. And I can see that as a newer therapist, we get so many people that are from all of your individual niches, baseball, gymnastics, fitness athlete, golf, and I think you guys have treated them so well over time that it just keeps expanding, and we get so many different kinds of athletes now. And I think it’s all the things you guys have touched on: communicating with the person. I think that was a change from the insurance model to this when I joined Champion is getting text messages all week at any time of day, and you just find that the person is so invested in their own outcome. Maybe that’s because they’re paying cash that they really want the best service possible, and you want to provide that for them.
So, I think it’s really a combination of things where you guys have just treated these niches so well over time. We just keep getting more and more people from different backgrounds and treating them well and responding to their needs that they reach out to family and friends, or like Mike just said, we have, just in my year, year and a half there, have a lot of repeat clients that when something else pops up, and they shoot me a text. And we decide if it’s something I can just send them, and they don’t even need to come in, or if it’s something, let’s come in and get this eval, and give you a plan. And I think that’s just the other big thing is in the cash-based plan, you have to be comfortable. Some patients you only see once every three or four weeks, and it’s having them manage a lot of stuff on their own, which I think is different than the insurance model as well.
Mike Reinold:
Yeah, I think that’s great, Kevin. And, just again, a good way of putting it together a little bit. When you put yourself out there, and you truly care about helping that person, I mean it’s like you’re becoming part of the family, and you have to treat them that way. So everybody wants a guy. So, you’re talking to your buddy, and you’re like, oh your shoulder hurts? I got a guy. Everybody wants a guy. But you’re putting yourself in that position to be like, I get somebody I can refer you to. Because I know these guys are going to go that extra step, and they’re not going to be embarrassed by that recommendation. They’re not going to say, “Oh, go to this PT place.” And then the person has a bad experience. I think they feel comfortable they’re going to have a good experience from that. So great stuff. Dave, what do you think?
Dave Tilley:
Yeah, mine’s pretty quick. I mean, it just came up yesterday. I was talking to Dan. Dan, just give me a thumbs up if I can blow your spot up a little bit. But he was asking about what’s the best starting advice to find a place? And I think it’s under-appreciated how much you have to actually sacrifice to really make it as a good clinician, but also just someone who wants to work in cash-based, especially up front because I had you two to help me with a schedule early on, but still I had to live pretty tight on a budget for three months to make sure I could transition out of a consistent paycheck every time. And I had to put in so many hours outside of the clinic to do well to research problems and figure stuff out and go to courses and read.
And I think that’s underappreciated out of new grads, which is in this screen right here, we probably have 3 to 5,000 hours of unpaid hours this year of stuff that we’ve just done. Reading, research, trying to figure out finding a doctor, late night text messages, coming in early, sitting in traffic to get there because somebody needs a time that you only have. And I think that’s just undervalued as a new grad. You have to really be willing to eat dirt a little bit in a positive way, investing in yourself in the future. And I think that’s what you and Lenny did early on, which was like, you got to go in at eight because somebody needs you and somebody else needs you at one. Well, you got to go back at one to help that one person out. And I think sometimes that mentality’s got to be adopted a little bit early on as a new grad.
Mike Reinold:
I like that. Because we’re there to serve. It keeps coming back down to that. Everybody always asks, how do I need to learn something? It’s really hard to open up your own cash-based practice by yourself if you’re not good at your job. And that’s almost like assumed, you have to be good at your job to be able to do that. But then from there, everyone’s just like, well what do I need to do to get better? And all we do is recommend them books on customer service and human interactions.
How to Win Friends and Influence People, To Sell is Human, Start with Why. These are all the books we recommend people start reading so that way they understand this process of service-based industry. I think that’s pretty neat. Diwesh, Jonah, anything from the gym side? I mean, I think it’s very similar where you guys want to be almost like the training concierge to some of these people, and I’m sure they’re texting you late at night about how do I add 10 pounds, right? There’s probably something going on. Anything you guys think is part of the key to your success at Champion in the gym?
Diwesh Poudyal:
Yeah, I think pretty similar to what you guys have already said in terms of making sure that you’re really building the relationships with people, being available at all times of day and stuff like that. I think, on the other end, I think you mentioned it just now, but being good at what you do does go a long way. If you’re not getting results for people in the gym, if you’re not keeping them injury-free and getting them stronger, faster, bigger, more powerful. If you’re not helping them with their goals, then they’re probably not going to keep coming back. But if you can keep providing them value as far as making it goal-specific to them and helping them reach their newer heights, then you’re probably going to have people that are going to like you for a long time and respect you for a long time and recommend you to other people for a long time. So, that’s a good one. That’s really what I would say.
Mike Reinold:
Yeah, that’s a good one, too. And I think in the PT world we’re guilty of that. I mean I guess in the training world, too, we’re guilty of that sometimes: you’re working on your goals for the person, not their goals for themselves, right? You have your own plan in your head. It’s not about you; it’s about them. But what do you think, Jonah, anything else to add?
Jonah Mondloch:
I think, just in general, being a place that other places aren’t. So, going back to the original question of the cash-based PTs, set yourself apart by, I think what you guys do, is having a massive gym there where you can go in and people are doing sled pushes or doing legitimate workouts as part of their PT. And I think from the gym side, us having you guys right next door is a massive piece of it, where somebody rolls an ankle or something happens, and we can just get one of you to check it out real quick. And I think that provides a ton of value. So having that back and forth to create an environment that you wouldn’t get in just a typical gym or in just an insurance-based PT, I think is something that’s useful and awesome aspect of working at Champion.
Mike Reinold:
Right. Yeah. And not just having it but having the right staff that is ego-free and collaborates, right? I think that’s the key part of it, too. All right, great stuff Corey. Great question. Hopefully that was helpful. I think that was pretty good. I think there’s a market need. We’ve been talking about this. Dan Pope really wants me to talk about this more, but we got to do some mentorships where we’re helping people with some of these things because I think there’s some shortcuts that we can help you guys with. So, I don’t know, we’ll say maybe that’s an Easter egg, Dan, for anybody that made it to the 18th minute of this podcast episode. But hopefully it’s coming when we put our heads together, and it can start helping. But if you have questions like that, head to mikereinold.com. Click on that podcast link and ask away, and be sure to head to Apple Podcast, Spotify, and give us a rating and a review. Subscribe. We really appreciate it. We’ll see you on the next episode. Thank you.
