We officially launched Roscoe Physiotherapy Co in the fall of 2017. In the months leading up to it, we had channeled all our extra time and energy into making this vision a reality. We both left our jobs that year and decided to go all-in on this ‘all or nothing” idea. We had also taken Paul’s Accelerator in the spring of that year, and used it as the foundation for how we positioned our product and services moving forward. We are a hybrid practice located in a small rural town in Western Pennsylvania, the closest city is Pittsburgh about 60 minutes south.
At the time of conception, it was just the two of us – Anthony treating ALL the patients & running the biz side of things, and Marissa managing the office – scheduling, phones, marketing, etc. At that time, I don’t think we realized what was actually happening – that we were actually building a business.
It started as more of a means to remove ourselves from our current situations/jobs where we both dissatisfied and seeking more – more fulfillment, more purpose, more freedom to live life on our own terms. Honestly, money was not so much even on our radar. We knew we needed enough to make the bills and support ourselves, but anything beyond that, we saw as a huge bonus.
For most of the first year, we didn’t pay ourselves. Every penny made went back into the business.
We operated with very low overhead (per Paul’s recommendation), and lived well below our means. By summer of 2018, we were starting to max out the schedule. Within months, it had grown from 5 or 10 visits a week, to 25, then 40 and 50.
We were still the only employees (actually, volunteers would be the appropriate term), and floating between 25-30K gross revenue per month. At that point, we decided it might be OK to pay ourselves something, so we decided on the salaries that our accountant advised were “reasonable” for the job roles (but at the very low end).
I still remember attending the Columbus Mastermind that summer, and feeling like we weren’t ready to join Paul’s Mastermind program. Looking back, it was limiting beliefs and straight-up discomfort that held us back. Operating with low expenses and a minimalist approach is something we built our business on. It allowed us to grow quickly, and optimize what we had. But as Paul often says, what gets you started will likely get you STUCK – and we HAD to learn to SPEND the money we were making!!! Needless to say, we joined Mastermind at the event in Columbus and took on the next level of Paul’s coaching community.
On the way home from that event, on the three-hour drive back to Hermitage, PA, we worked on a presentation that we were giving the following week. We had been offered the opportunity to speak as a monthly guest at an event with a local independent living facility. It’s worth noting this singular event and its timing because it was one of those instances where things just align for you, you get an opportunity, capitalize on it – and it can propel you to the next phase of your business. This speaking engagement was one of those instances. (I could note three or four BIG opportunities over the past 3 years that have helped us to take our business to the next level each time – this is something I fully attribute to trusting wholeheartedly in God’s plan for us, not anything we were able to do on our own).
So, we prepped our presentation on the drive home from Columbus. We were READY to tell 100+ seniors about low back pain and how we can help them resolve it – WITHOUT the use of pain meds, injections, or surgery! It seems almost comical looking back, but after the talk – we had a line of at least 50 individuals looking to sign up for a consultation. Of those people, we converted some 50% of them. Our schedule was booked with evals and new patients for months! And we served those clients with absolute top-notch service – something we strive to keep at the centre of all we do today. Word of mouth took over as our primary lead generator. We were building a buzz around what we were doing, but to us, it probably seemed more like a blur!
There was basically a domino effect from that point on. We brought on our first staff member, a per diem PTA, in the summer of 2018, to service our current clients and also the influx we had from the independent living facility and increasing WOM. We also added a part-time PT Tech/Office Assistant around the same time. We now had a team of four. In 2019, the growth continued. We made that big step of hiring our first physical therapist, which was scary – but much needed. And PAUL GOUGH even visited our clinic! This was an epic, “once in a lifetime” type of experience for our team. We were still very much a fledgling business. Our team was young, we were inexperienced leaders, and there was so much yet to learn and endure. But we continued with the same energy and excitement for our mission as we had when we started.
By 2020, we were on the trajectory for more growth. We joined the CEO Mastermind program, and set generally predictable revenue goals based upon our growth trends. Starting 2020 felt good. We were building a foundation, and learning so many lessons in real-time. Of course, just a few months into 2020, Covid hit and it became apparent there would be another shift.
But there were actually so many positives to the situation. We were a small business, so we could adjust and pivot. We had the right mindset and the right team in place to keep moving forward, despite what was happening in the outside world. We had our own corner of the world, a place where happiness and positivity were endless; there were no bad news headlines or drama or nonsense. It was our escape, for us, our team, and our patients. Aside from a few slow weeks early on in the Covid months, we stayed steady and our business and team grew.
We spent A TON of time on recruiting in 2020, the first time we’ve actually followed through with a hiring process and not hired off of emotion or feelings. We launched and relaunched our front desk hiring process four times, going through over 600 candidates in the course of the year. We made the hire three times, the first offer we made, the employee resigned the day before their start date. The second hire quit after one week on the job. Now at our third hire, we found an awesome fit and the right individual. We also hired another PT after losing sleep over some fantastic candidates who are now warming the bench. This hire was also our first time planning for growth, versus reacting to it. We are now working to build out a legitimate and robust marketing plan, to optimize our team, and build up cash reserves to invest in our next location.
Starting off 2021 we are a team of 7 and then some: two FT PT’s, one FT PTA, one FT Customer Service Admin, a CMO, a CEO, a PT Tech, a part-time finance team, and Paul’s entire team which we utilize for supplementing our marketing plan as needed.
At our 2021 annual planning meeting, we had a moment. Walking down the hallway of our modest office space, we stopped and looked at each other, Anthony making the comment “I guess we are doing OK after all. We actually have a legitimate business.” And now, the best is yet to come…
Five Marketing Campaigns’ That Boosted Our Profit
- Online Fitness Group – When Covid hit, almost immediately we launched an online strategy to continue building a virtual community and serve our client base. With gyms closing and lockdown in place, it became apparent that people needed help and an outlet. The online fitness group made the most sense. We launched to roughly 75 people in April, and started providing weekly virtual workouts to the group. It worked out in that it was led by Marissa which therefore resulted in most of the members being close to our Perfect Patient demographic (women who want to workout/get in shape but need help with knowing where to start and how to do it safely). We positioned the business as a “sponsor” to the community – each week Anthony went live in the group to answer their specific questions about fitness, health, preventing injury, getting better at running, how to choose the right shoes, basically anything you could think that a group of women wanting to get in shape could have), and also sent out a weekly “Fitness Fax” similar to Paul’s weekly marketing fax. We grew our list and also converted members to PT plans of care through this process. The group continued through the end of the summer and is still available today for members to re-watch the videos and resources we provided.
- Facebook – We implemented a weekly Facebook Live strategy dubbed “FAQ Friday”. The public had the opportunity to weigh in on topics they wanted to hear about from our team (we also strategically chose the topics to fit our perfect patient).We went live each Friday for approx 30 minutes from April through July. We covered topics like what to do when the gyms shut down (which they did), safe tips for working from home, gardening and working in the yard without a week of back pain afterward, etc. In conjunction with the live chats, we created different special reports, e-books, flyers, etc. to correspond with the topics we were covering, positioned as they give at the end of the videos. This helped us grow our list, increase engagement with our Facebook audience, and generally get our faces in front of more people (omnipresence). We also featured different patients who were willing to come on Live with us and share their “success stories” (basically, a “live” testimonial video).
- Mailers – One thing we really enjoy is providing something tangible to our clients that they can feel and hold and touch. Whether that’s the shock and awe box, golden ticket, or sending cards through snail mail. For Covid, we thought that people may be missing the personal interaction and conversations that they were used to (especially the older clientele who were more restricted than others). So we decided to send them things through the mail. One piece that worked well was a “just checking in” letter with a pamphlet for tips to stay active and healthy while stuck at home. It included some simple tips, a photo of our team, and each staff member signed the letters with a little note. We got several calls and emails after sending those to our Medicare population, as well as some patients reactivating to plans of care.
- Omnipresence/PR – We accomplished in two big ways. The first is that the business was featured in a local magazine titled “Valley Voices”. We actually got chosen because several of our patients persistently reached out to the magazine and asked them to feature us. The article was an in-depth look at the history of the business, where we are today, and who we help. We ran a corresponding ad in the magazine targeted at the geriatric population. We received calls from that article for probably up to six months following its release, and would probably still be getting calls if we continued to promote the article. We also teamed up with a friend & local pastor who runs a very popular local podcast. The podcast features local business, community, and political leaders who are working to make a change in our state and local community. It increased the general awareness about our business and elevated our status within the community.
- Infusionsoft – We FINALLY started implementing Infusionsoft in our business. We hired Paul’s team to start the welcome and discharge sequences, special reports, birthday and follow-up campaigns. This has greatly helped us to improve quality control and manage patient concerns as it gives them direct access “to the CEO” where they feel safe to express not only their satisfaction but also possible concerns, so that we can handle those before they become a bigger issue. We also started sending our emails to our list more regularly. The most successful email sent was a 2020 “Message from the CEO” which generated A TON of past patient responses and engagement from our community.
We Used the Benefits of Paul’s Mastermind Program to Boost Our Confidence in Our Business
- Facebook Group – We consistently use the group to search for different topics or resources that we are dealing with in the moment. Many of the issues you will run up against have already been addressed within the group, making it more efficient to find solutions, or ask questions. If you need a resource, marketing piece, email sequence, or just quick access to Paul’s team, you can undoubtedly get that from the Facebook group.
- Planet Paul Newsletter – It is great for helping to spark a quick idea for me. I will often pick it up when I’m looking for some direction or idea and it never fails to give me several ideas I can direct focus on implementing.
- Weekly Q/A Calls with Paul – Not only do we make it a point to be on the calls live each week, but we replay them constantly – Paul’s voice is frequently in the background at our house. We share them with staff for them to have access as well. When Anil was doing the weekly calls, we would start each Monday morning with his gratitude calls to set the tone for the week.
- Monthly Strategy Calls with Barry/Simon – We set up weekly calls with Barry during the Covid months of March and April. These were very valuable in improving communications and sales for ourselves and staff. We were able to really maximize our “downtime” when the schedule wasn’t as full with learning opportunities that helped for future business growth.
- 2-Day Meetings – Last year it was great to be able to share the Mastermind weekends with the entire team. For the two virtual events, all staff members attended and we used it as a team learning event. They all found it massively impactful and look forward to future events. Prior to Covid, we made an effort to be at the in-person events because that time away from the business and in the Mastermind environment is just invaluable.
- Accountability Groups – Never miss a call! These bi-weekly calls are HUGE for our growth and mindset. It can be tempting some days to skip the call when you are busy or have a lot going on, but every call proves to be critical to our choices and growth over the two weeks that follow. It keeps us focused, accountable, and most importantly just having a tight-knit group to laugh about the ridiculous things that happen in your business make it worth it.
- Networking with other members – Again, just utilizing other members not just for knowledge or resources, but for a community of people experiencing similar things that you are going through is huge. Not only do we have people we can reach out to, but we are able to be a resource for other members which is very rewarding.
Our Three Biggest Challenges This Year and How We Overcame Them
- I almost lost my dad in 2020 – I’ll never forget the call I got from my mom after my dad’s initial consultation with the heart surgeon. On Monday of that week, we were expecting a routine stent. By Thursday, we were facing a very serious and emergent quadruple bypass complicated by significant aortic stenosis and a less than optimistic prognosis (referred to as the “widow-maker” blockage).The next month of my life was a blur. I had to take a temporary leave of absence from our company. Myself and my dad would travel daily back and forth from Cleveland Clinic (just under 2 hours one way) for a week or so in pre-op testing and appointments. In a cathartic way, these long drives were nice. We were able to just spend quiet time together and talk. Surgery itself was a challenge, as secondary to Covid precautions, I was THE only person allowed at the hospital throughout my dad’s stay. Through the grace of God and the steady hands at Cleveland Clinic, my dad’s surgery was a success and he continues to be on the road to recovery several months later.I have a quiet rule that I keep to myself but employ in all aspects of life. It’s what I call the 24-hour rule. Get some bad news? Things don’t go your way? Some unexpected challenge has come your way? Well, you have 24 hours to sulk. When you wake up the next day, you have no choice but to become razor-focused. You HAVE to become the leader. You HAVE to face the challenge head-on. You have NO TIME to feel sorry for yourself if you want success. Thinking back to the day of the surgery and seeing my dad initially postop, I really have no idea how I held it together. Not one ounce of anxiety or uncertainty. One hundred percent stoic and balanced. Ready to be the rock.I implore you all to live life with this rule. Be the leader you are looking for. Be the solution to life’s problems. Be the support system of those around you who haven’t yet found their own personal strength to BE the foundation yet (although it DOES exist within us all).
- Our business survived (and thrived!) during a pandemic – It’s moments like this when you question your sanity for being a business owner! Seriously, I reflect again and say “how did we ever do it?” One thing most humans cannot stomach is massive uncertainty. We like to know WHAT is happening. It makes life a little more comfortable. However, I’d argue that uncertainty is something every SUCCESSFUL business owner learns to fall in love with. In March 2020, we were making life-altering decisions BY THE HOUR. Literally, everything was changing so quickly and no one had any idea the extent of what was to come. The pressure was big as our company employs eight people in some capacity and various other local vendors. As a healthcare organization, we were encouraged to stay open and provide medically necessary services to those at risk and in need. It was vital for us to both serve our employees and our clients at the HIGHEST standard. Without much guidance at the time, our leadership and adaptability skills were challenged. Another rule of life I live by is that I take responsibility for ABSOLUTELY EVERYTHING that happens to me. Taking extreme ownership of your life is quite empowering and allows you to become solution-focused. Covid would’ve been any easy excuse to blame business failures on, however easy does not live in my DNA! We got focused on getting better EVERY SINGLE DAY. Not just for the sake of ourselves, but for the sake of those WE SERVE. In the end, our business thrived, we were able to add two more people to our team (yes we hired during covid!), and we served a record number of people in our community SAFELY! The caveat I have for decision-making is one of our primary company core values: Always do the right thing. When applied to life in a self-aware and critical manner, you will be assured to make decisions from a place of “doing what you feel is right” as opposed to seeking to “be right”. The outcomes are liberating and life-changing.
- We got married! The greatest asset an individual can have in life is a partner that embraces their crazy dreams, supports them, nurtures them, and dives headfirst into them with you. I couldn’t imagine being on this journey without Marissa. It would be WAY less fun and exciting (she is an enneagram 7 after all :). Our relationship has been challenged and grown strong over the years due to our willingness to embrace being uncomfortable and practicing radical transparency within our home (and business).I believe in having an internal and an external anchor. Something and someone that helps to keep you grounded and in control of your emotions in very difficult times. Marissa is my external anchor. Weightlifting is my internal anchor. Find something and someone you CAN TRUST to keep you grounded in reality and focused on your strengths, while not succumbing to the thoughts that hold you back from achieving your greatest purpose in life.
The Top 3 Things We Did This Year That Helped Grow Our Clinic
- Joining the CEO level of Paul’s coaching world
- Recruiting & Hiring
- Stepping away from Patient Care
Recruiting and hiring staff has been huge for us in 2020. We were able to fill two key positions to replace both myself and Marissa to free us up for higher leverage and business growth tasks. Hiring is very scary when you are first starting out. Once you get a solid grip on your numbers and understand the cash flow and income generation of your business (with proper tracking), it makes the decision much more objective and straightforward. Joining CEO helped us to achieve that level of clarity for our business. By keeping an open mind and listening, we’ve been able to learn so much from all the other business owners in our CEO group that has benefited our business.
Finally, stepping away from patient care has really freed up time to focus on the tasks every business owner should be doing (aka not the daily tasks). I continue to work on improving my focus on the main problem and completing the most pivotal tasks.
Three Pivotal Mindset Shifts That Led To More Profitability And Our Best Year Yet
- Better understanding the “idea and concept” of money – I spent a good amount of 2020 improving my relationship with money. Growing up, I learned to have a conservative financial approach to money which has been very beneficial in helping us to get where we currently are, however, I needed to learn and understand that it would NOT help us get to the next level. My focus has been on utilizing money as a tool to buy back my time for high leverage tasks and business growth, as well as investing in infrastructure and automatization of our business with the expectation of future ROI. Too much money sitting in the bank is losing value and NOT helping you to achieve your goals. I’ve learned to move away from my attachment to safety and being more progressive in investing into growth (while always making sure to keep a healthy cash reserve in case of emergency J.
- Getting comfortable with doing business growth work – As a PT it is easy to fall back into “treating patients” because it is tangible and has a definitive start and end. Focusing on business growth feels much different. Some days you aren’t quite sure you’ve accomplished anything, even after putting in a full day of work. Learning to understand and accept that high yield work does not produce immediate impact has been greatly beneficial in helping to further expedite our clinical and personal growth.
- Be an observer! – Paul spoke about this on one of our Wednesday calls and this has strongly stuck with me since. When you make an effort to objectively look at your situation and problems, and remove the emotional aspect from them, you are in a much better position to efficiently solve the problem, as well as see alternative potential that you would never see with the clouding of emotion. In all situations, this has helped me to become a better leader for my family, my business, and my staff.
Two Specific Achievements We Made With Our Staff
- Recruiting – Spending time on refining our recruitment process has netted huge gains for our business. I utilized Paul’s Hiring book initially which was very helpful in creating a replicable system to attract and find high level candidates. We had one FD hire that did not work out, however it really helped us to hone in on the specifics of our FD job success and the qualities and core values we needed to find. Our newest hire is much more suited for success in the position and our initial failure helped tremendously in identifying holes in our recruitment process.
- Accountability – We were able to improve accountability with staff by implementing weekly scorecards and consistency in reporting our clinic numbers each week at our Monday morning meeting. Our therapists are responsible for reporting their completed POC’s and “drop-off ’s” from the week prior. We delved deeper into KPI’s and critical drivers at our annual planning meeting and introduced new scorecards for all staff. Finally, we started a Front Desk and PT dashboard to help better track our patient’s status (current phase of rehab, recommended visits, current visit number, potential for ancillary sale items or services, potential for drop-offs) and recognize when increased action is needed to prevent drop-off or potential for sales.
3 Ways that Paul’s CEO Mastermind Program Contributed to Our Success:
- Accountability – Having made the personal and financial investment, you have an increased accountability to stick to your goals, take a close look at the numbers/objectives, and report back to a group of individuals you respect. Without accountability, the likelihood of sticking to a goal is much less.
- Elevated thinking/big picture – The group provides a constant reminder service to remove yourself from the day-to-day thinking and go big picture. You learn not to be so concerned with the granular things and focus more on the big outcomes. What’s more, you see other achieving things and realize it is possible for you, as well.
- Community / Support – More than anything, having a group of people who are going through similar things is invaluable. So many processes can be expedited by the resources within the group, not only through the other members but by having access to Paul’s entire team of experts.
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