In October 2016 when my wife was 3 months pregnant with our first son, I made the decision to quit my full-time stable job with benefits to start a company with a business partner.
With inspiration from Jarod Carter, my business partner and I were planning to create a cash-only PT practice aimed at treating young active adults.
After a year and a half, our cash practice was pathetically having 3-8 visits a week.
We put a lot of effort into creating a home health contract therapy company while neglecting progress towards the cash practice.
This was not the direction I wanted the company to move, so in June 2017, I separated from my business partner and basically started over.
Those of you that have gone through failed partnerships can understand when I say this process was very stressful and is comparable to going through a divorce.
I took over the underperforming cash practice, moved locations into a smaller 400sq ft. space, and began to rebuild.
At the same time, I switched my Perfect Patient to a 50+ individual who wants to stay healthy, active, and independent and enrolled in Medicare.
We now are enrolled in Medicare and are OON with all other insurances. With my experience in home health, I identified an opportunity within senior independent living facilities and began offering treatments at one of those facilities and my small clinic.
At that time, I had no office staff and 1 PTA. Over the next 2 years 9 months (end of 2019), I had grown our team to 3 PTs, 3PTA, 2 STs, 2 OTs, an operations manager, marketing assistant, and front of house front desk.
We were providing home visits in 5 senior living facilities and moved our clinic into a 1200sq ft. space. In 2020 we were off to an amazing start with record-breaking months in Jan and Feb.
Like everyone else we took a hit in mid-March and dropped to about 50%. We were able to quickly return to 100% pre-covid numbers by June.
In addition to adding telehealth as an option, we added a Virtual Group Wellness Program that now adds a small additional revenue stream to our practice and has the ability to scale in the future.
We have 5 full-time PTs, 4 full-time PTAs, 2 OTs, 2 ST, billing/ scheduler, operations manager, marketing assistant, and a front desk.
Five Marketing Campaigns’ That Boosted Our Profit
1. Virtual Happy Hours – In 2019 we were heavily dependent on in-person lecture series at our senior living facilities.
In 2020 we were not able to provide this in person due to Covid protocols.
As an attempt to stay engaged with our client base, in mid-April, we started a virtual happy hour where we interviewed local health experts weekly at first, and then monthly until September.
It is hard to give a direct ROI on this but I think it helped us stay connected and helped us return to our pre-Covid numbers by staying in engaged until they felt comfortable to return.
Secondly, it gave us a reason to send print materials to them each week.
Even though many of them did not join virtual they still receive the print material advertising the happy hours which help keep us top of mind.
2. Newspaper Ads – Similar to 2019 we continued to use newspaper ad series timed with a workshop.
This time we did them virtually rather than at our clinic. We usually run a 4-part series every quarter and the ads run every other week.
The first 2 ads are content with soft calls to action “call for more info” followed by a free report ad and then an ad for the workshop at our clinic.
We try to filter the free report calls into the workshop as we have a very high conversion rate from our workshops.
The most successful topics for us are Balance and Fall Prevention and Low Back Pain and Sciatica.
3. Virtual Workshops – We didn’t start these until about July. We are committed to doing these monthly in 2021.
They were much more successful than we expected considering our older patient population. It was also nice not to worry about capacity limits at our clinic.
4. Google Ads – We started in 2019 and tried to manage them ourselves.
This year we decide to sign on with Paul’s team to help. After a bumpy start, things are moving along.
We are getting consistent leads that are not Medicare age. One big goal for 2021 is to increase cash/OON ratio to 20%.
As a team, our conversions from Google have not been as successful as I would like, however, Google Ads are going to be a must in achieving this goal. Now we need time to work as a team on converting from Google.
5. Consistent Print Newsletters – From January 2109 we committed to a monthly print newsletter and were able to continue in 2020.
Again, it’s hard to track direct ROI but I very much believe these newsletters were vital in getting us back to pre-Covid numbers.
We were able to educate people and handle objections in the newsletters.
We pitched several of the articles focused on the consequences of not getting help and the consequences of reduced activity due to the isolation recommendation and requirements.
We Used the Benefits of Paul’s Mastermind Program to Boost Our Confidence in Our Business
1. Facebook Group – Prior to CEO I relied on the Facebook group a lot; the Facebook group is great for tactile questions and motivation for when you get stuck.
However, I found that since joining CEO I have not been as involved in the Facebook group.
I found myself comparing myself to others and deviating away from my plan in order to implement something someone else was doing (shiny object syndrome).
I still check in to see what’s happening with the group, but because of the very clear plan and direction, I walk away with from CEO I have less need to look for more ideas on FB.
I have learned through CEO that it is often not about doing more things but doing what you already do better.
2. Planet Paul Newsletter – At this time Planet Paul is a great reminder of key concepts that Paul and other contributors are teaching.
I used to read it cover to cover. Now I skim it for articles specific to my problem at the time. It also serves as a reference library to refer to later when new problems or projects arise.
3. Weekly Q/A Calls with Paul – Early on after Covid, the daily calls with Paul were very helpful in keeping my thoughts rational.
More importantly, it helped me better lead my team through the craziness.
To be honest I have been inconsistent with the calls through the second half of the year. I do miss the mental reset button that the calls provide.
4. Monthly Strategy Calls with Barry/Simon – Sadly I have not taken advantage of these.
5. 2-Day Meetings – It has been great getting the entire team involved with these events. As always I take 1-3 things away from these meetings.
Several times this year I would ask my manager team to re-watch some of the sessions. I really do miss in-person events and can’t wait until we get back to that consistently.
6. Accountability Groups – I have been inconsistent with this. I have started a regular 1 on 1 meeting with a fellow CEO member.
Like I said about the Facebook group, when you are in CEO the plan becomes very clear.
I’m sure I could get a kick up the butt every once in a while and the prep alone for the meetings is valuable.
7. Networking with other members of the Program – Surrounding yourself around like-minded people is important.
Running a business can feel lonely at times. You can feel that it is you against the world.
My wife mentioned to me earlier in the year that my social life has really decreased since joining ‘this Mastermind thing’.
I responded “This Mastermind thing is a huge part of my social life. Many of the people in Mastermind and especially in my CEO group have become and will stay lifelong friends!”
Our Biggest Challenges This Year and How We Overcame Them
Covid – Do I need to explain more? Things were moving along really well pre-Covid. In fact, we had our 2 best weeks ever during the first 2 weeks of March.
If we would have continued at that rate, we would have broken our all-time monthly revenue by 12K. We ended the month at only $1500 down from Feb.
We dropped about 40% in the first 2 weeks after Covid. We have a high PVA and because of our great February and early March, we were able to ride the wave for a while.
We also were very consistent with check-in calls for those that dropped off the schedule.
We started a group virtual wellness program and we also did a weekly Austin Health Experts Happy Hour which helped give us a platform to educate people, stay relevant and remind people of our value for when they were ready to return.
Front Desk – We hired a new front desk coordinator in June after the previous one graduated from UT and returned home to west Texas.
She quit after 4 months to take a better-paying job. This was a good reminder about “keeping the bench warm”.
We started the hiring process ASAP, however it took us about 8 weeks to find her replacement.
This was a really hard time for the other admin staff (marketing assistant and ops manager).
I did my best to jump in and assist, as well as helping them prioritize tasks. Some things were put on the back burner but we survived.
The Top 3 Things We Did This Year That Helped Grow Our Clinic
1. Consistent Marketing – We found consistent ways to stay connected with our current patient list to help minimize drop-off and to help with reactivations once lockdown restrictions were removed.
This consistency has allowed us to build trust and stay in front of our perfect patient.
In addition, consistent newspaper ads, Health Expert Happy Hours, monthly newsletters, and adding Google Ads all played a role in our success.
2. Getting the Best out of my team – I really feel I grew as a leader this year. Last year I talked about my mindset shift from wanting to be liked to wanting to be respected.
This as well as just taking the time to make sure the entire team is OK mentally was helpful in keeping things moving forward productively.
At times as I would start to feel better about our situation, I would have to remind myself that the staff are probably a little behind and need reassurance that everything is going to be OK.
3. Moving people on – Removing 2 mediocre team members and replacing them with A-players – We fired one PTA and performance managed another out this year.
Looking back I’m not sure why we didn’t do this sooner. Having everyone on the same team pushing in the same direction is so much easier.
A Pivotal Mindset Shift That Led To More Profitability And Our Best Year Yet
Not worried about losing staff by holding them accountable – I mentioned earlier that I made the mindset shift from wanting to be liked to wanting to be respected.
However, at times I let a similar limited belief hold me back from holding people accountable. In the back of my head, I am worried about them leaving.
Having the confidence to hold people accountable has made a big difference in our standards.
I continue to reinforce this mindset with our manager team because I can tell they have the same limiting beliefs.
Two Specific Achievements We Made With Our Staff
1. Mid-year our therapy manager was starting to lose focus. I was getting the feeling that she was overwhelmed and that the job was too big for her.
In one of the CEO check-in calls, we discussed a plan to performance manage her out if she did not turn the corner.
I ended up having a heart-to-heart with her over a margarita and found out that she was feeling a lot of financial stress due to her boyfriend being out of work and she admitted to poor spending habits.
She was rushing through her duties so that she could drive Uber Eats for 2 hours after her patients. Her admin/ manager duties were slipping.
After the heart-to-heart, she stopped her driving role and has really stepped it up in the last 3 months.
2. Early in the year, right before Covid, we hired a marketing assistant.
We had been without someone in this position for about 4 months.
Early in her onboarding I invested a lot of time teaching her principals and teaching her the why behind what we do from a marketing perspective.
Although painful at times, the hours invested have paid off big time.
Using the 10-80-10 rule we are able to pump out way more material than before because she understands the why and basic principles.
3 Ways that Paul’s CEO Mastermind Program Contributed to Our Success:
1. CEO always helps me come away with a clear plan. This year has been a little crazy and the plan gets derailed from time to time.
However, just the discipline to prep for the meetings is valuable all on its own.
Not being able to meet in person was not ideal as I really enjoyed the time getting away to think. However, the virtual format works and is better than nothing.
2. Having close friends who understand the struggles of business ownership is vital to my mental health, this year especially – It is nice knowing that you aren’t alone and that you have 9 others that you can count on whenever you need them.
3. Learning from other CEO sessions.
It is amazing how many times I take more information away from the other sessions than I do from my own session.
Putting yourself in the other group member’s shoes and helping work through the plan helps me flex my decision-making and strategic thinking skills.
It’s hard to quantify but because of this, I feel I am more prepared to make better decisions when in similar situations and have a better thought process for making those tough decisions.
Join Paul Gough's Exclusive Business Success Mastermind Program for Physical Therapy Owners
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