I grew up in the UK. I went to PT school in England and shortly afterward, moved to the USA.
I purposely worked in a variety of different settings and gained a broad experience of Physical Therapy and how it helps people in their lives.
I have always favored outpatient as I feel it offers the greatest opportunity to make meaningful changes for patients and allows more autonomy for the clinician and business owner.
Although I always saw myself in business, it was kind of a dream for a while and I struggled with the idea of taking so much risk, especially as I was married with three small children and with my wife, Melissa staying at home, we had no backup income or Plan B contingency.
What really pushed me was an illness I suffered for a couple of years in my late 30s. I found myself in a hospital bed, midway between two surgeries.
My employer had gone bankrupt and my medical insurance was canceled.
I realized that life was short, I could not rely on others to provide important things like income and medical insurance and the best time to do anything was now.
So as soon as I was well, I set out to open my own office.
I’m very fortunate that I have a life partner who believes in me and is willing to let me take risks.
I founded Jones Physical Therapy in August 2005 by taking out a loan on our house. I also decided not to do a side gig but to go all in and devote all my time to developing the business.
Two weeks into the process the first bump in the road appeared in the form of the infamous Hurricane Katrina.
Our town was badly damaged, there was no power for almost a month and we had to leave the state for a few weeks just to stay safe.
Then we returned to assess the damage and pick up the pieces and try to start from there. This was halfway through building out the clinic.
The funny thing about these types of things is they teach you what’s important in life (family) and that it’s OK to take big risks. I mean, what’s the worst that could happen?
One result of the storm was a huge surge in population to our area from parts of the state that did not fare as well.
This meant there were a lot of new people needing my services who had no established providers, I think in the long-term this helped accelerate my success in the face of this potential disaster.
This year, we are celebrating 15 years in business and now we have 2 locations 30 miles apart staffed by PTs and PTAs, plus techs hired form the local university Kinesiology program.
We live in a small community so we tend to treat anything that comes in the door within reason. These people are our friends and neighbors and many of them have been coming off and on for years.
Over the years I have tried many different types of advertising: I wrote a column in the newspaper for a few years, I had an ad at the local movie theatre that got a lot of comments.
I had a billboard, I even sent an athletic trainer out to local high schools and sports facilities to triage injuries and refer people to the clinic.
In 2016, Louisiana became a Direct Access state and we started to change our marketing focus towards the public rather than traditional referral sources such as doctors.
I soon realized that talking to people about PT was different from talking to doctors and my caseload was still a majority doctor referred with a small number of self-referred.
In 2017 I found Paul Gough and signed up for New Patient Accelerator and started my journey to getting more patients directly and learning how to take care of them once I had them.
Five Marketing Campaigns That Boosted Our Profit
1. Infusionsoft emails and follow-ups with dedicated inside sales position – I wrote out and scheduled a full year of emails with 4 quarters devoted to the neck, back, shoulder and knee respectively.
We added special offers such as a Veteran’s Day deal which was very popular and we also have a monthly newsletter.
I hired a staff member who is dedicated to follow-ups so we have a steady stream of reactivations.
2. Hired an outside company to do Facebook ads – I used to do these in-house with better results but since my focus is elsewhere I decided to put this on autopilot until I can come back to it.
I have good ROI so it can continue until I need to focus more attention.
3. Outside Sales position – In March I hired a dedicated Outside Salesperson. She was charged with nurturing our current referral sources and prospecting for more.
The program was successful and I created training materials and scorecard for it. The original sales rep got off the bus and we are currently hiring her replacement.
Having training materials and an accountability structure in place makes this very easy to do.
4. Employee/Member Appreciation Days – In 2020 our goal was to bring our staff to a workplace or a gym twice a month to provide hands-on services as a type of reciprocal offer or Discovery Visit.
This has been very successful in the past so we were looking forward to making this a regular offer this year.
Unfortunately, Covid prevented us from holding many events in the second quarter, however as the year progressed we were able to find more prospects and had several events that yielded referrals and prospects to nurture.
5. New Website – Our website host is moving our website to a better platform to enhance SEO and improve opt-ins.
As I write, the new website is ready and we are about to switch the domain name and publish it.
We Used the Benefits of Paul’s Mastermind Program to Boost Our Confidence in Our Business
1. Facebook Group – I go to the group whenever I have a general question. I always read other people’s posts and give answers and advice wherever I feel I can be useful.
I also check in with my CEOs regularly when they need help and when I have a more high-level question and need some specifics or perspective.
My staff also attend Tech Thursday for help and clarification and problem-solving.
2. Cash is King Newsletter – I love to read this, sometimes the information is new, and sometimes is stuff I need to be reminded of.
Recently I read an article titled Income Follows Assets that reminded me that the basis of all good businesses is good employees who are well trained and feel empowered.
3. Weekly Q/A Calls with Paul – I often sit in on the Wednesday call to hear Paul’s message for the week.
In 2020 these calls were particularly helpful as we entered lockdown and found ourselves in new territory.
Paul helped us all understand that this is going to pass and that we should focus on what we can do to prepare for things going back to normal eg. retaining our customers and being a source of positivity in the community instead of panicking like everyone else.
4. Monthly Strategy Calls with Barry/Simon – Have done a few, and those have been helpful. I probably should do more.
I spent several invaluable hours this year with Cameron going through Infusionsoft and streamlining some of the processes we have in place.
Cameron also helped me train my inside salesperson.
5. 2-Day Meetings – I have attended as many as possible since 2017.
I really enjoy the presentations, the guest speakers, and getting around the group to have those one-on-one conversations.
Getting away from the clinic and having a few days to learn and contemplate is priceless.
6. Progress Groups – I’m part of Group J: The Accountables.
I have attended a few sessions, but to be honest CEO meetings are what I focus on mostly for my own accountability.
I feel that as a seasoned clinician my best role in Group J is to assist people in the group who are getting started in business or starting to hire new people or come up with success strategies.
7. Networking with other members of the Program – I network all the time through email and messenger with Mastermind members and with my CEO group.
Having so much brainpower “on tap” is one of the greatest advantages of being a part of this program.
Three of Our Biggest Challenges This Year and How We Overcame Them
1. Covid-19 – Initially we shut down by 75% as patients and staff alike were gripped by fear and uncertainty.
I had several meetings with my staff to implement a plan to move forward while keeping everyone as safe as possible.
I assured them that although I did not know the eventual outcome, we were all working hard to move forward and adapt to the situation for the best possible result.
We implemented Telehealth initially, even though the reimbursement was uncertain because we knew it would keep customers engaged at the very least.
One of my PTs really enjoyed staying home and doing Telehealth so she took all those cases and her PT team member continued to see all the face-to-face appointments in the clinic.
PPP funding helped us bridge the gap for a while until we could get back up close to 100%.
What I learned here was that I have some great team members who are willing to do whatever it takes to keep the clinic up and running.
2. Staff – As we moved through 2020 we had many changes. We had to fire a PT who was not following our instructions.
Another PT moved away with her husband who is in the military. Fortunately, we hired two new PTs who are a great fit and doing an excellent job.
At the front desk, we fired three people and hired one. Staff we let go had been hired without following the proper protocol and as it turned out they were a poor fit for the job. Lesson learned.
We hired a new biller, again someone who we did not hire by our current protocols and was not following our systems.
We hired an outside salesperson who did make a difference, but once again did not follow our systems and had to be let go.
We take the attitude that all this happens for us not to us and that if you have a poor or mediocre team member they do more damage than good so they have to go.
The last two staff members I let go were not only not doing the job, but they were also causing drama with other staff members which illustrates that if you don’t get rid of bad employees early, they can cause a lot more damage.
3. Covid 19 again – This time I got it as well as my wife, Melissa (who is the GM).
This meant the clinic had to run itself for a while with minimal intervention from either of us.
Fortunately, all our hiring, training, and systems worked perfectly and the team was able to manage everything in our absence.
As I write I am on week 6 of not going into work and everything is OK. We had to push our annual planning meeting to January but that’s OK.
The Top 3 Things We Did This Year That Helped Grow Our Clinic
1. Incentive-based pay for Physical Therapists – I have always wanted to have an incentive-based program for PTs.
Straight salary tends to make a provider look forward to slow days and not enjoy busy days.
When part of their compensation is based on productivity they look at things from the opposite perspective: slow days = bad, busy days = good.
This brings them more into line with how I see the clinic. In addition to changing the pay structure, I also allowed therapists, as a team, to set their own hours within the framework of the clinic hours.
This meant that if they worked harder and hit their goals early, they could take more time off.
Or if they needed to leave early or take a long lunch, with the co-operation of the team, they can do so. This led to a real mindset shift amongst staff.
I saw more strategic thinking and higher numbers each week, as well happier providers as they are able to manage their own time and achieve some more work/life balance.
2. Dedicated Outside and Inside Sales – I had previously thought that sales are sales and that one person could handle any and all sales positions in my small company.
I learned through my CEO sessions that the types of people who do inside, outside, and internet sales all have very different personalities and skillsets.
So, with this in mind, I set out to hire different people for each position. This has worked fairly well in its first iteration.
I had a staff member with some experience in telesales who trained to operate Infusionsoft and all leads follow up.
So far she has been successful and producing results. I hired another person for outside sales, she was someone who had sold print advertising previously.
She did a reasonable job but could not follow all our systems and had to be let go.
I talked to some friends in pharma sales and they suggested either someone with experience in pharma or people who have experience with sales in cell phones as that is where most pharma reps come from.
Currently, we are considering a candidate with pharma and medical device experience.
3. Refining and updating training materials plus hiring new staff – In 2018 we implemented a ‘Ladder to Success’ for each position in Jones PT.
This consisted of 12 weekly modules for each new hire covering everything from values to scorecards.
This year we refined each ladder and tasked some of our current staff with making video modules for things that are easier demonstrated than described.
Our inside sales/Infusionsoft specialist created a series of emails and videos to support each program.
We implemented a longer hiring process to assure only good candidates got offers. At the end of the year, we have a much better team than we had at the beginning.
Three Pivotal Mindset Shifts That Led To More Profitability And Our Best Year Yet
1. Income Follows Assets – I have mentioned this before, and I heard it a long time ago, but often I know the script but I don’t learn the lesson.
Or maybe I just need to learn the lesson more than once.
We have spent a lot of this year focused on getting the right staff and then making sure they are thoroughly trained, accountable with clear goals and objectives, and happy.
If you focus on this, the money will arrive.
2. Learning how to value a company – At CEO, in one of those side conversations we all talk about, I was introduced to value investing.
I took a 13-week course on how to evaluate publicly traded companies just by looking at the numbers. This made me think about my own company.
What is its value? What makes it competitive? What would I score as a manager? What would make someone want to own my company as a stock-holder?
3. Profit First – I implemented Profit First in late 2019 and refined it further in 2020, the first full year using this method.
By understanding more closely how to budget for each category of spending in my company I was able to get through Covid, avoid any unexpected expenses and pull $55K out at the end of the year which I invested to start another business.
Two Specific Achievements We Made With Our Staff
1. Incentive programs across all positions
2. Ladder to success for each position
3 Ways that Paul’s CEO Mastermind Program Contributed to Our Success:
1. Accountability – I recognize that I am the type of person who needs external accountability (Gretchen Rubins “Obliger”).
Being part of a group is what motivates me to do the things that need to be done partly because I don’t want to let the team down. As part of a small group, you can’t escape scrutiny.
2. Staying out of the fray – In CEO, we are trained to think like an owner, not an operator.
As an entrepreneur, it’s easy to jump in and do things because that’s what we are good at, and to some extent that’s what makes us happy and feeds the ego.
What is harder is the transition from someone who is always there and always busy to someone who can hire, train and empower other people to do the work without having to look over their shoulders all the time.
3. Helping other CEOs solve their problems – Being a mentor or partner or member of the board is not only personally gratifying but is also gives clarity and perspective when trying to solve your own business problems.
Many times our group emerges from a session with a big ‘aha’ moment that we can use over the next quarter.
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