Healthy Wealthy & Smart 465: Dr. Eva Norman: A Physical Therapy Wellness Practice
On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Eva Norman on the show to discuss her cash based physical therapy business. Eva Norman, PT, DPT, CEEAA is the President and founder of Live Your Life Physical Therapy, LLC, 100% of cash-based business since 2013. It is the first mobile medical wellness practice in the country run by an inter-professional team of physical therapists, occupational therapists, speech language pathologists, personal trainers, acupuncturists, massage therapists, health coaches and dietitians dedicated to optimizing health by transforming lifestyles through innovative wellness, fitness, rehabilitative and preventative services. The company’s success can be attributed to standardizing an approach to develop a life-long client, transforming lifestyles through care collaboration, and mentoring and investing in their employees.
In this episode, we discuss:
-The shocking story behind how Eva was introduced to physical therapy as a teen
-How to attract and maintain patient flow with a mobile cash practice
-The benefits of virtual assistants for the operational side of business
-The importance of maintaining a connection with your network
-And so much more!
Resources:
For more information on Eva:
Eva Norman, PT, DPT, CEEAA has been practicing physical therapy for nearly 20 years. She received her B.S., M.S. and Doctor of Physical Therapy degree from Thomas Jefferson University in Philadelphia, PA. Through the years, Dr. Norman has practiced in different practice settings with patients of all ages with various diagnoses. Early on in her career she developed a strong interest in geriatric rehabilitation. To expand her skill set over the years she has taken numerous continuing education courses and also worked in the areas of neurology, orthopedics and cardiopulmonary rehabilitation. In 2013, she became a Certified Exercise Expert for the Aging Adult.
Dr. Norman, an active member of the American Physical Therapy Association since 1994, has served in numerous roles. She is currently serving as the MN Physical Therapy Association’s (MNPTA) Federal Affairs Liaison, MNPTA Delegate, and PT Political Action Committee Trustee Chair. She is a member of the private practice, home health, geriatric, health policy and neurology sections.
In January 2013, Eva founded Live Your Life Physical Therapy, LLC in response to her passionate desire to offer to her clients, patients, and the public, services both in home and the community that could help them to experience health, wellness, and a more active lifestyle throughout their life spans, through the creative applications of preventative and rehabilitative physical therapy, occupational therapy, speech therapy, personal training, acupuncture, massage, health coaching & dietary services.
Read the full transcript below:
Karen Litzy: 00:01 Hi Eva, welcome to the podcast. I'm so excited to talk to you today. As a lot of people may not be familiar with your story quite yet, but those of my listeners who are know that we have a lot to talk about and we could've gone in a million different directions here from advocacy to APTA membership to the PT pac. I mean on and on and on. But what I really want to know, I'm being selfish here, would I really want to talk about is your business, so live your life, physical therapy. It's a really interesting business model, I think. I think and I hope that a lot of physical therapists will trend into your business model at some point. But before we get to that, can you tell us the story behind it? What is the why behind the company?
Eva Norman: 00:57 Yeah, it's quite a long story, Karen. But yeah, that definitely will help you understand why the model is the way it is. So when I was 13 years old, I was involved in a hit and run accident. And actually this was actually the weekend before I was going to go trial. I was headed to nationals or I was trialing for the Olympics and swimming. And so it was pretty life changing. My coach said, don't just go do something fun. And so, ya know, I just don't really have the best balance and obviously hindsight's always 20, 20, I don't know what crops go roller skating with my girlfriend, but I did. And so I was literally going across this crosswalk and the 72 year old man who wasn't wearing his glasses that day and drinking, unfortunately instead of hitting the brakes at the accelerator right at the left side of my body, I'm pretty much fractured all my major bones in my left leg that I honestly referred to myself as road kill, to be honest, for a long time.
Eva Norman: 01:56 And it was very, very traumatic. I was rushed to the hospital where I was told that we needed to amputate within 72 hours. Cause that's all of my ability that we had the femoral artery. There was just, I mean, just a really weak thready pulse. And I come from a family of healthcare professionals. My father's a physician and my mom's a surgical nurse and my team took me home. They told the doctor that they would respectfully disagreed with his conclusion, obviously the diagnostics that had been made and they were going to take me home and have me heal there. So, which is pretty, I know, right. And I just remember being hooked up to morphine and thinking like in shock, of course I'm still in shock, but I trusted my father, but I just remember thinking, okay, how's this going to go?
Eva Norman: 02:47 And I remember the doctor saying, you realize you're leaving the hospital AMA. And my father's like, I perfectly understand that and I work here. So yes. And so they took me home, they converted our living room into a hospital. And, I was going to the hospital for outpatients though. So the one thing my father did ask, the surgeon is to order outpatient physical therapy because at the time, sadly, there wasn't home care for kids. And even today, as we all know, there's very limited. And so I went to outpatients. You're not even going to believe this, but I had anywhere from two to three times a week at non-weightbearing for nearly four months. This was years and years ago. And so, my parents essentially the range of motion through stretching do it, just retrograde massage, acupuncture, and honestly, incredible nutrition.
Eva Norman: 03:49 So during this time, actually I got very depressed. As a matter of fact, I tried to commit suicide during this time. And so it was really dark hours, I'd have to say during my life. And I got really depressed when my father came home to tell us that our insurance had exhausted. And so you can imagine having two to three times a week of therapy for that long period of time. No wonder we reached our annual cut so quickly. And so, my dad asked the hospital if they could see me privately and they said, no, we don't do private pay. And, then my dad was like, well, do you know any other providers in the area that could do this? And they're like, no, we don't know anybody.
Eva Norman: 04:34 So of course my dad literally opens up the yellow pages. Remember back in the day we had yellow pages and just calling anyone and everybody and couldn't find anybody. I mean he researched high and low. They couldn't find anyone outside of where we were from. We're actually from a little town called holiday for Pennsylvania and couldn't find anybody. And so he took the director of the rehab program there at the hospital to breakfast one day. And he asked her if she would consider coming. And the reason is because, you know, people have often asked me like, who is your physical therapist? To be honest, I don't remember. I still don't, it's very foggy. And I've actually looked into this that it was multiple people, but the person I did remember was Jean. So she was the director of the program. I'm not going to share her last name.
Eva Norman: 05:22 Jean, if you're listening to this, hopefully someday you'll listen to this cause God knows you've heard my story before. But she is very modest and she's okay with me calling her Jean. But anyhow, I would love to share her name. I was interviewed and she said now just by first name and I'm like, okay, I want to share that because a lot of people want to know who she is. And so the person that I remember is her, cause I connected with her, she was in PR. She was honestly, my cheerleader walked in always the high fives would always give me hugs and I left. And so my dad took her to breakfast and begged her truly to come over and she said to my dad, you know, you realize I haven't touched a patient for two years.
Eva Norman: 06:04 Like, why would you ask me? I'm like, the last person you would see your daughter, you know, and my dad's like, but she loves you. She's connected with you. And she thinks that physical therapy, you're the person she remembers. And so she just come over, you know, I don't know, just talk to her. I'm just worried. And, of course my dad shared with her about the fact that I was so depressed and so I think that's really what motivated to come over. And I don't really know that she knew what she was getting herself into, but that day was honestly very transformative. And I use that word there because it truly was, she gave me hope that day. I might get emotional here cause it is very emotional for me. But she came in and it's just this holistic approach that she had.
Eva Norman: 06:49 The first thing she saw me, she said it was just this picture of depression. And she came over and gave me a hug and I honestly didn't want to let go. And, she's like, you know, she said to me, she goes, when was the last time you saw your friends? I'm like, it's been months and you know, it's been four months. My mom has me on isolation here. Essentially you're donning gloved right now because my mom's still afraid of infection. And she goes, no, I'm just, yeah. And she turned and looked at my mom's, of course, my parents are sitting there in the room and she said, you know, she needs social interaction. She needs people in her life and you know, is there any way, I mean, her friends could come over and gown and glove like I am.
Eva Norman: 07:27 And it was at that moment, I think the light bulb went off in my mom's head. Like, what have I done? You know? And so my mom, my mom is like, you know, of course she's like, you know what, I'm going to call your best friend's parents today. We'll have them over for dinner. And of course, my mom's solution, everything was always food. So I had this big dinner that she, of course, Christmas staying for. And then the next thing you know, Jean asks me, she's like, your dad tells me you're not doing your schoolwork. And you know, it's all about like, you know, she's like, you love to read. Your dad says you don't even want to read anymore. And I said, Jean it's the concussion. Cause that's something I forgot to mention earlier that I had sustained a concussion.
Eva Norman: 08:04 I'm having a hard time focusing. I'm still seeing double, you know, I'm just having a hard time concentrating and she goes, but you have the TV on. I said, I can listen. I just can't read. I just am having a really hard time with that. And she goes, well have you been doing your exercises? I think she assumed that the PT that I worked with gave you exercises and like no one's ever addressed it. No one's ever assessed it. I don't think anybody even knows that add one, except for the doctor that told me I had one. She goes, Oh my gosh. Then you could just tell by the look of her face. She was just livid. Like, gosh, how are we not addressed that? And she turns to my dad's, she goes books on tape. Remember back in the day we handle, yes. You know, that will be a great solution.
Eva Norman: 08:45 You know, she's like, go. And of course my dad's like, Oh, library down the street, I will get every book imaginable. Great idea. So moving forward. Then the next thing she says, she's like, she's like, now I understand why I haven't been to church and do you actually went to our church? And she's like, I understand your mother doesn't want you leaving this house, literally these four walls. And because she's so afraid that you're going to, you know, obviously end up with an infection. And she said, but you know, I know sister's been calling here a lot and we've been praying for you. Like, I haven't wanted her to come over. And, you know, and it was just an, and I just remember at that moment, I mean, my parents had asked the same question and I finally admitted, I said, you know, I just feel like a failure.
Eva Norman: 09:25 You know, they had just, you know, four months ago, they had this pep rally for me cause I was heading to nationals or I was going to try nationals again. And you know, I was just so happy about that. And I just honestly felt like I failed my town and my failed my school and who had, okay, there's so much time into me, like coming in, rooting me on everywhere, honestly. And, and so and she goes, no one cares about that. All right, let me be happy that your alive. And an amazing family. And she obviously was telling me everything, but you know, obviously I should be thinking, but I mean, that's really what it was, honestly eating away at me. And so, and I said, you know what, and she made me realize that that's just, that's not important.
Eva Norman: 10:07 Right? And she goes, well, would you welcome communion? I mean, is that something important? And I honestly broke down at that moment because, you know, I really thought God had abandoned me. Just for her, just to even offer that. And so I welcomed it and she's like, well, you know, sister and I were going to have dinner tonight, so how about she come over tonight as well? So like I said, that day was just amazing for me. And so just knowing that sister would come over with really miss a lot. And so as you can tell, I mean, just even just with these few little things I have shared, I mean, it was just such a holistic approach. She hasn't even touched me yet, but yet cared about, social, my emotional wellbeing. And so then this next piece she was like, okay, today for therapy we're going to take a shower.
Eva Norman: 10:54 Cause clearly we need one. And so she's asking me about like, where do you shower? I said, well, my mom washes my hair in the sink and then, you know, I sponge bathe in the bathroom, so where's your shower? And I go, well there's one in the basement. Went upstairs, but I can't do steps. And as she goes, why can't you do steps? And I said, well, my leg is just very unstable. And so, it obviously is very painful still. And, and she said, well, why couldn't you go up on your bottom? And I said, well, I don't know how to do that. Can I do that? I remember my dad, like I just remember he was interjecting was like, wait a minute, does this say for her? And she's not allowed to anyway. She's like, absolutely. And of course rolling her eyes again.
Eva Norman: 11:32 How is it, my staff is not addressed this right? So don't we see that a lot in home care? Clinics don't even ask you like how many steps you have or where your bathroom is and so forth. So Jean shows me how to get up there. She has, my mom had her wrapped my leg, literally had my first shower on the second floor, I mean, in four months. Oh my God. And then I get into my bed for the first time in four months. And so now I'm just crying uncontrollably. I'm just so happy. And it truly, I honestly have hope for the first time. And,I remember her really close to me on the bed and she literally grabs me and like my two arms pretty firmly. And she looks at me like really close and she's like, yeah, Eva do you trust me?
Eva Norman: 12:16 I go, Jean, I love you. Like, and I'm sorry and I'm going to get emotional right now. I'm like, of course I trust you. And she said like, why don't we have you back? She's like, well, we're not done yet. We haven't done exercise yet today. But she's like, I will be back. She's like, I want you to know is that you will walk some day. Do you believe me when I say that? Yes, I do. And this was, I mean, of course I've been told by, I mean we had had numerous specialists now, you know, had okay examined me and it was like conclusive apparently according to them. It wasn't scary. Oh, it was. And so that day was the start of a whole new life for me. And, I mean literally eight months later.
Eva Norman: 13:03 Tell them this is the day I was walking with no deficits like in or anything, it really was amazing. He was coming anywhere from two to three times a week. But who did she bring along the way? She brought an OT. She brought a speech therapy because of my concussion, I also ended up with you have ADHD as a result. And I also worked with a dietician to work on my nutrition. I had massage because I had a lot of pain on my leg. Chris, I had mentioned it's an acupuncture earlier. So good luck even today at live your life. I was just thinking that is all said and done. My mom made. So I made two promises, went to my mom. Okay. My mom promised God that if I lived that we would give back. And so from that day, like literally my mom had me volunteering at every PT location, whether it was adult day program, LPP, clinic, you name it.
Eva Norman: 14:06 I was there when I applied to PT school. I had 3,600 hours of volunteer hours. And that was all with my mom. And, then of course today you could see why it means so much to me to give back to them that I love so much and I'm obviously long story how I got into government affairs, but I think that honesty is the best way that I feel like I have to give back. And then, with regards to the promise that I made my father, my father made me promise it some day I would have a business where I could help others in similar situations. So it's very personal to me and obviously it's kinda been like this healthcare ministry in a sense to me. I'm very spiritual but it's just also just become this. Yeah, just something that I'm just so passionate about.
Eva Norman: 14:50 And so I started out, so the company started with just physical therapy initially. It's because I would do what I knew best and what I felt comfortable with. And just so you know, by the way, Jean is still my life helped me get into PT school, had my first clinical with her. And the time I graduated, she has seven like thriving clinics all over Pennsylvania. I mean she's doing as she's teaching the last that she sold her businesses now teaching on a penny towards retirement but still doing amazing. And so now I feel like I'm somewhat following in her footsteps and so like it took a while though cause people always ask, they're like this is somebody that you obviously had this promise to make and cause I was afraid of failure to be honest.
Eva Norman: 15:48 And it sadly took this horrible job to finally take the plunge to be honest. That's usually how it works though, right? And so, I'll never forget the day that then I left that job, which honestly was great day, but my husband said, you know, good for you because this is literally how the company started. And so we go to Buka is you know how they have like the table nets that are just, you know, okay you could with crayons, right. All over and so forth. And we wrote my business plan downstairs just on crayons and stuff. He wrote like generic little business plan but then coming up with the name. Right. So how did we come up with live your life? So I mean we had another sheet, all these words that were meaningful to us, right as a couple.
Eva Norman: 16:35 We had thought of that cause we don't, we talked about the business for so long and Dan was so supportive of this and so, and I remember like, I mean they're literally words live like these words are everywhere, you know, in physical therapy. And I mean there's was just like live, well I remember there's all these different like verses, you know that I envisioned it so forth. And I'm not even kidding you, but I have to share this. Cause people always ask like, how did you finally come up with that? So we're sitting there and you know, there's music always jam and right. And sure enough, Rihanna comes on the side, live your life. And I'm like, and I literally called Paul walk at that moment, he was like business lawyer. I’m like file it right now.
Eva Norman: 17:16 Like file it right now. We're not changing our buys like you know, and so we filed literally that day. So it's just such a great name. As we're putting the business plan together, of course this is something I had thought about for quite some time, but the common thread, cause I had been doing home care now at that point. I'm sorry for how many years I been doing at point 10 years. Yeah. At that point. That was almost seven years ago. January 2013. Yeah, I would say essentially open our door I think. But at that point, what I was most frustrated is with the, the noncommunicable diseases, right. From an unhealthy lifestyle. Such like retention, that diabetes, obesity of your RDCs, you know Karen, stroke, cancer, some of the things that truly, I mean that are honestly draining our healthcare system and we're going bankrupt as a result.
Eva Norman: 18:21 And I'm like, so much of this can be prevented. And I'm so sick of seeing the vicious cycle again and again, repeat patients over and over and over again. I meant seeing them, you know, or it's the pneumonia with the hip fracture on and on and the multiple falls. So it's just this just crazy. I'm like, gosh, we had to do better. And I've always had such a passion for prevention, hence my background where I kind of brought in right. You know, just that holistic approach and just going well beyond just rehab. And so like every patient just prior to this was always going home with some type of what I would call a wellness program. And so I knew I wanted to go in that niche, but I wasn't sure kind of, you know, who to target. Right. And I should start small initially, but you know, I dunno, can I never go small?
Eva Norman: 19:12 What are those things where you just go big or go right, So yeah, let's do the whole spectrum. Since my head said safe and they're like, okay, how about it? Because this all happened to me at 13 we go 13 end of life. Perfect. Let's start there. And it truly is 13 end of life by the way. Still today. So, okay, so that's our target market and then, okay, so who, and what are we going to target? I'm like everything, everything, every noncommunicable diseases, things that we can prevent, those are going to be, those are going to be like their target things. And so of course they started doing research throughout Minnesota to see where, what towns do we target. I mean it was amazing.
Eva Norman: 19:53 I found out that like the city of Minnetonka has the most falls than any other city, which is not far from here. And I found that out by looking at the emergency room statistics, you know, so just started targeting like different cities based on, you know, some of that I'd been doing and done that was out there obviously for anyone to find. And so then I'm like, okay. And of course it was just me initially. Right. And I was thankful that I was doing my, it’s called a certified exercise expert for the aging adults certification around that same time. And, my lab partner happened to be a PT that wanted to go to cash based business. So it was like my first hire. It was great. And so because I quickly knew right away that I needed to have a backup cause I'm like, I'm never going to be going on vacation, you know?
Eva Norman: 20:43 Okay. Right. And how am I going to be able to, you know, continue to grow and he was willing to be that back up who were great by the way. He is now these actually now in Chicago, and doing amazing things with his cash based business but regardless. So we started small, but then I was able to, through those connections and through the certification I was able to identify like all their physical therapists that kind of wanted to start cash based businesses. So targeted them. And then I started teaching at the different universities to connect with other professors, not necessarily wanting to hire students that the professors, because a lot of times they're paying for a part time work. Right. And I thought, yeah, let's target health and wellness professionals. So it was great to kind of, that's how it started and got made.
Eva Norman: 21:36 So by the end of year one we had four PTs, one personal trainer and a dietician. And so, and it's not that I didn't want to, you know, third discipline, it's just that we couldn't find the right people. Right. That one perhaps like to be out in the community. But also that one to go you mentioned kind of area, right? Because it was NC state. I mean that was, you know, almost seven years ago. So back well defining terms in the house delegates.
Eva Norman: 22:12 For OT and speech was difficult, but sure enough, a connecting. Like I said, it's all been through relationships to be honest. Everyone that I have hired, it's literally a friend. I know someone for your mom that will work well with you and I'll see. It's been great. I was just thinking about that as earlier today. Kind of, you know, just start team. We were just thinking, because I'm planning our Christmas party right now. Like, you know, there's eight individuals that have been with me since the beginning. There's 25 of us now, so seven PTs. We have one OT, one speech therapist, five personal trainers or massage therapists, a health coach, a dietician in for admin staff and myself. So 15 of those individuals are employees and 10 are contractors.
Karen Litzy: 23:10 And so if we can just talk, I love the fact that you said you kind of did your research into different towns and tried to see what each one of those towns really needed. So when you are seeing your clients, you had mentioned your cash based, do you take any insurance at all? And so when you’re seeing patients more towards the end of their life, you know, a lot of them are Medicare beneficiaries and we had a little chat about this before we went on the air. So, and this is, I'm sure you get this question a lot. How are you seeing those people?
Eva Norman: 23:45 Absolutely. Thank you for the question. So end of life would be a lot of patients that are receiving hospice care. So when I can think of end of life, unfortunately a lot of the hospice is in the area only. We'll cover two, maybe three visits at the most of physical therapy so that we have great relationships with all the hospice here in the twin cities. So they'll refer us. Cause a lot of times, you know, people are like, I don't want mom in bed. You know, I don't want her last days to be that. She loves to walk. She loves to, you know, go downstairs and spend time with the grandkids or whatever.
Eva Norman: 24:33 So I want you to keep doing that. But I want a professional to help her do that safely. And given her medical, you know, history, you know, her medical complexities, right. Obviously. So, so they hire us. But of course sometimes it's not just physical therapy they may want, sometimes it's just, you know, sometimes they may want a massage because it's just soothing and comforting and so forth. Because they have, a lot of times they have pain and so forth. But sometimes, you know, they'll stop eating and they'll hire even our speech language pathologist to figure out, like, is there something that we could do perhaps to help stimulate the taste buds or give her perhaps mechanical soft diet or something as different type of diet perhaps to help her with eating.
Eva Norman: 25:20 And then sometimes even to our dietician will get hired as well to pick up, how can we get enough calories? We have, and I'm really happy to say this, we have had 15 at this point, 15 clients outlive hospice due to our wellness program. Yeah. Remarkable. And so, Oh, how does it work? Right? Like how do people get into our system and how do we figure out. These are the disciplines that you need it. So, absolutely. So they'll call, they'll call, they'll call 'em. You know, we can call a number. So my admin by the way, are all virtual. They're all virtual assistants.
Eva Norman: 26:06 So I have one person that literally takes the calls. So there is a series of questions that they get asked and we've actually created an algorithm. So based on how their answers are, you are headed, you know, you're obviously recommended certain different services. Now of course my admin isn't clinical so they don't make ultimate decisions, but they can kind of help start that conversation of where, you know, what they're thinking that perhaps they could benefit from. And so I take that algorithm, the results of that, and then I set up a telehealth free consultation. We do 30 minute free consultation because typically, I mean they have some questions and of course because it's cash, they should. And I open that conversation to like as many family members as they want. You'd be amazed. Like I'm, sometimes I have like the whole family because the family's paying this for mom.
Eva Norman: 26:57 Or, you know, the son that's in New York. And then, another cousin that's really involved in Texas or whatever is, you know, is on the phone is on this call. So, that's why we've started to do tele-health, calls. They want to see who I am and obviously want to meet their therapist. And that's like a great opportunity to explain, okay, so according to our algorithm, these are the services that we feel that you would benefit from. So I kind of explain what those services exactly will do for them. And then prior to that conversation, I'm also packaging something for them, you know, depending on what we think would work best for that individual given what I already know about them, I try to package some things so that they know what it's going to cost them.
Eva Norman: 27:43 They don't have to, there's no, we don't have any contracts or commitments they have to make, you know, it's obviously up to them. They can start in whenever they'd like and see us as frequently or not as frequently as they'd like. So it's really up to them. We make our recommendations, but ultimately they make the final decision. And we based that after assessments. Cause a lot of times like I'll give them kind of a ballpark of what I think it could be just based on, you know, other experiences with similar cases, you know, it's really going to come down to really determine what would be best. We always think that way. And then at that point is really when we finalize the numbers as far as what that looks like.
Eva Norman: 28:28 And they obviously will make some times their decision as far as what they want to do. But oftentimes they do want to meet. Like who would be the dietician, just want to see if that's a good fit for mom or dad, et cetera. But it's interesting how it's usually the sons and daughters that are hiring us. And you know, we do 13 to end of life, but I'd say the majority of our clients are over the age of 65 so the majority, but yet we have the full, we do like, I mean actually my youngest right now I do, I do have a 10 year old gymnast right now that's actually a professional gymnast that is trying for Olympics. So injury-free they’re amazing. And our oldest right now is 103 and on hospice, you know, people here in Minnesota live a long time. Amen. I'm going to have a hundred year olds for that matter. We have about 15 clients that are over the age of 90 right now.
Karen Litzy: 29:42 So that's amazing. I mean I really liked this business model and I am a huge proponent of physical therapy being the forefront of wellness care because we're educated for it. We understand co-morbidities, we understand surgical procedures, past medical histories and how best to formulate a good plan of wellness for people. And I really, really feel that, you know, what you're doing in Minnesota is certainly something that can be replicated across the country. I mean, I always tell people like, Eva has a home care business in Minnesota. I mean, it's fricking cold there and there's no way. Like if she could do it, like anybody could do it. Everyone always asks, well, I don't know. I live here. Would I be able to do it? I'm like, let me tell you, yes, yes you can. You absolutely can. It just takes a little bit more work, you know, and it's a different mindset, right? Because you're all of a sudden going from in a clinic where people are just coming in one after the other to now you have to make up your schedule. You have to fill that schedule. It's not as, it's not like, I don't know about your practice, but I know with mine, like I got six new patients in the past week. Week and a half. That's a lot. You know, now in a regular clinic that might be like a day, but when you're going out to people's homes and they're paying you cash, that's a lot of new patients. So how do you guys deal with, you know, your new patient flow?
Eva Norman: 31:09 Absolutely. Great question. And so, I have to tell you this year, this time of year, so it's fall and spring are our busiest times and I'll tell you kind of why. First of all, right now they're getting ready to head South for the winter. So they're trying to get themselves as strong as possible before the holidays because they want to go to Florida, Arizona or Texas don't make sense. And then in the spring it's those that had been sedentary on the couch all winter long and suddenly they come out in the spring and sure enough things are not working the way they hope to right. Because they haven't been moving. So that's where high season. So right now it's if a 10 grit, good question to ask. Cause we do have a waiting list. It's it honestly. But what happens with the waiting list? Cause I don't think that's good customer service.
Eva Norman: 31:58 I ended up out in the fields. And so that's because a lot of times people ask me like, when do you add more PTs? Like when do you decide like you need to hire that next person. So when I get to the point where like three quarters of my week, I'm literally spending in the field, it's time to hire. And even just one week of that is like enough for me to say yes, it's time to hire an as a matter of fact work. We have a full time position right now. And I actually, I'm out now part time, but still I would say, but that's still a lot and I've been consistently that now for a while. So, yeah, we're actually down to final interviews. So I hope to have someone hopefully by next year. But that's kinda how we make that decision.
Eva Norman: 32:43 Before, it used to be like three months consistently, but now I've known that if it stays that busy, especially this time of year, it generally stays the same. Oh, and I haven't really had anyone that I've been able to, like I've had to like, you know, go from full time to part time because essentially once we have them, I keep them busy. And that's one thing too. I should probably share what's also help at this model is that it's kind of a level playing field. There's no, I mean I have the bottom up management style. Like everyone has a voice here and so everyone contributes. Everybody has a project and so perhaps developing a wellness program around what they're passionate about. So we have probably about seven projects going on right now and so just the individuals that not everybody has to do it.
Eva Norman: 33:33 But right now there's seven individuals that are developing programs around one is looking at cancer. One is looking at diabetes right now. One is looking specifically at dementia. One is looking at dementia, the other one's Parkinson's. And then we are looking at cardiac disease. Develop your like a cardiac rehab program for the community. Like for people they can't get to like the actual, you know, hospital for their cardiac rehab. And I think there's one other ends. Oh, concussions one on concussions. Huge. So those are kind of, I think that was seven. Does that sound like seven. But those are currently actively being utilized and we have multiple disciplines working on one project. So like for example, for like the dementia program, we have a personal trainer, we have an acupuncturist and a physical therapist working on that specific program.
Eva Norman: 34:28 And so they meet regularly on their own time, might be doing their own zoom meetings as well and meeting so that's sometimes we'll fill in the gaps when we have ebbs and flows. Cause as we all know in cash base world, it ebbs and flows. So that fills in their gaps. And so they know that they're always going to be full. So when they have downtime, they work on their projects, they'll work on research, they'll meet everybody, also has a mentor that which they're required to meet with regularly. So they might meet with their mentor. And also everybody is required to be a part of the professional association and in their professional association. So that might mean, you know, doing committee work might be on their downtime or you might have been asked to put a presentation together.
Eva Norman: 35:12 So they might be working on that. And you know, well up our time in so many different ways so it stays busy. So I share that because a lot of people say, well, what, what happens when there's downtime? So, but you know, all of that helps the business that leads to employee retention, professional growth in the course of the growth of the company. Which has been really one of the, I'd have to, one of the number one reasons why I think it's led to our success and our growth is because, we do empower them to essentially become these young entrepreneurs, right? And so many of them, you know, want to. So, so lot of times we do lose staff because what happens is they learn how to run their business and they go start their business. But I see that as success.
Eva Norman: 35:57 They don't compete with us. As a matter of fact, they end up taking their own little niche and they refer and we refer back and forth, which is awesome. So, really it is hard though. That's so much time and energy into them and to see them as always are, don't get me wrong, but you know, it's always great when I go to conferences and I see, you know, my young, you know my employees, my young mentees, you know, they're doing amazing things. So it's always, feels great to see that. So, but yeah, so hopefully so back to you. I mean, I'm sorry that's like, but in a lot of different directions there, but, as far as you know, we have one of actually answering your question a little bit more specific.
Eva Norman: 36:43 So we have this waiting list. But like I said, we have a dedicated, it actually monitors our schedules. You know, each professional actually has their own schedule and essentially schedules themselves. But when I say one, like if we see gaps, because they'll put, you know, if they want more patients, obviously you know, they'll put it on their schedules. Like I can take three X week. So she'll monitor that so that she knows of people in as people. And we broke up into four quadrants so for those who don't know cities, we essentially break it up into four quadrants. I'm down a new four 35 w and so we just try to keep people into your graphic areas so they're not driving all over because that's a real pain in the ass right when the snow comes down.
Eva Norman: 37:33 Probably a good hour one way. Although you might be traveling that some days, you know, seriously someday. And it has been pretty bad. Like last winter was horrible. It would take you an hour to drive just 10 miles, which is horrible as well. So, she's great about, you know, in keeping me up to date too. So her and I kind of work together as far as making sure that we keep people busy and so forth. So we might need to be reading perhaps referral sources. Oh, some people were starting, you don't, perhaps numbers are lowering in some people's schedules and so forth. But I mean, generally to be honest, they stay so busy. Yeah, I can't say that we've ever had a point where I had to be worried.
Eva Norman: 38:24 Like I always feel like there's more than enough that we can do and so on the projects too, our business and they get incentivized to bring in business so we bonus them and so forth. So, you know, people are, we really truly work very collaborative and well together to grow the business. As a matter of fact, one thing I should've mentioned earlier with this interprofessional team that we have established kind of, okay, how do we decide when disciplines come in? Like I need to have packaged something together for someone, you know, PT health coach or I'm sorry, PT, dietician. I think I mentioned speech therapist earlier with an hospice patient. So we meet once a week through zoom and we actually have a care conference while we go through some of these cases where we'll problem solve, you know, when can we bring in the next system?
Eva Norman: 39:09 Cause sometimes we don't want to throw everybody all, first of all they're paying cash for that. But also it may not be the best, you know, obviously may not be the best approach. And so we talk through that, you know, as far as who would be best right now, you know, and so forth. Like we just, I have a lady right now that the doctor's recommending like steroid injections for her back, you know, and of course we hear that all the time. And so, okay. So my acupuncturist gets on, she's like, tell her all about me. I'm like, Oh, I already have, you know. And I'm like thinking you might be the next thing because she's ready to like literally go with the steroid injection and possibly an opioid because she is so much pain. But let's have you come in.
Eva Norman: 39:46 And so, you know, we look at you, you know, sometimes one discipline may merge quickly just because of something like that coming up. So, you know, but again, we constantly communicate, we're taking notes, we share kind of even, you know, our notes that we take from care conferences. Sometimes I always say we need to eliminate sometimes let it marinate in the brain to see, okay, well Whoa, would work best perhaps or these patients, sometimes we need to really think that through. And depending on what's going on and perhaps finances to it and also the support or lack of support that they may be having. You know, and I think on, I'm very ethical to like, that's the other thing too, like if we feel that they can get a service covered elsewhere, we will share that with them. And we also try to help them figure out ways that they can get this covered. You know, there's a lot of associations out there. I don't know if you guys are aware that, you know, like for example, for a stroke, the national stroke association, both your local and national, they sometimes will have stipends out there for wellness dollars that you can actually apply for. So Parkinson's has done that stroke muscular dystrophy.
Eva Norman: 40:53 Most of them are multiples, so we'll have them tap into those resources. If you're a veteran, sometimes the VA has, well, you know, dollars set aside for that. We've found, we actually worked with a purple heart recently that was given 30 wellness visits being purple hearts and purple hearts out there. Take note that you might have a great deal with your wellness. And then all set. I'm just thinking there's also been just even private insurance plans too that sometimes have dollars for memberships and so forth. We've been able to negotiate with them to get them to use those dollars for our services. So, which has been great. So a lot of times just picking the phone and asking that question, is this possible? So, and you know, they're, you know, they're frequently trying to reduce costs, right? They don't want them in the hospitals. So they obviously appreciate what we're trying to do.
Karen Litzy: 41:44 That's great advice. I'm really glad that you brought that up. That there are resources out there that we can have our patients, we can help our patients tap into for financial resources. I think that's really important. Good, good, good. Very good. And now you had mentioned earlier that all of your assistants are virtual assistants. Where do you find your virtual assistants? Because I know that's a question that comes up all the time.
Eva Norman: 42:12 So, okay. So my virtual assistants are all, let's see, they're either in school or their moms. And they work out of their homes. And so I know that there's been, I've heard that there's virtual assistants that you can get abroad and so forth and things like that. You know, I actually just recently looked into that and she even had an interview ironically today with a woman in the Philippines, which it could be very cost effective. And I was just thinking more for just, there's just a lot of busy work behind the scenes, you know, of course with many different businesses I could save a lot of time and they're very efficient and I was just surprised like how fast they type and put spreadsheets together or actually can update some of our reports and things and wow.
Eva Norman: 42:57 This I think good. So, I dunno, it was actually, and she's very cost effective. So thinking about and haven't taken the plunge yet, but just like I said, learned about it recently and interviewed her today, but how do I find them? As I mentioned earlier that really works for us has come to me kind of handpicked from friends or they've reached out, you know, and they reached out because they heard about our company. And I have to tell you, even one of them is a previous clients, you know, that, you know, needed a job and you know, and it honestly was just the right time, you know, it was one of those things where it was, it was truly wonderful. She call it the right time because I couldn't believe that day I shouldn't say I was desperate, but I was at the point where like I wasn't finding what I was looking for and she literally, I could check off all the check boxes with her and I trusted her and I knew her. She was a client of mine and no longer a client of mine. So, and I knew she had a really strong work ethic and the hours would work perfect with her schedule. So, it just worked out.
Karen Litzy: 44:04 I think it's great cause I think a lot of physical therapists don't think about using a virtual assistant and it can be an economical way to get stuff done. So I think it's great that, you know, we kind of have that conversation around that virtual assistant and how yes, they can answer your phones or yes they can. Do you know, things like that that you would think that no, it has to be in your clinic, but if you don't have a brick and mortar clinic, then you really have to get creative and that's obviously what you've done at live your life PT. Now, is there anything else that you have found in the building up of this company that you would say to someone, boy, if you have the chance to do this to help your company, I would do it. Does that make sense?
Eva Norman: 44:59 Yes. Ah, goodness. Great question. Yeah, so you know, well, I should take you back to, you know, and also just some. Yeah, it definitely. I would say the one thing that I wish I would have done from the beginning that has helped so much since I started the business. So this would be for the new business owners I'm joining and I have to put in a plug here for the private practice section. I joined the private practice session a year into my business and I wish I had joined them prior to that would've been great cause then I, through that network of individuals, I actually ended up with two tremendous mentors that have helped me so much. When I first started out, I didn't really have a whole lot of money for all, you know, contract develop. I mean I had a lawyer and so forth, but I couldn't afford necessarily to have him generating all these contracts for me week after week after week.
Eva Norman: 46:01 Cause I would just, you know, I ended up meeting a lot of contracts initially but was really great. Is that I found some tremendous mentors. And I'll name them Sandy Norby, Mark Anderson and Tim shell. I thank you. Thank you. Thank you for listening to this podcast. You guys seriously helped me. Tremendous. I mean save me thousands and thousands of dollars, just sharing what you already had. And just getting me going and just also giving me the confidence and I wish I had had that. I mean, I wish I had met them prior to starting the business, you know, cause then it would've been so hard because I think I was trying to reinvent the wheel and little did I know, like there was all these people that could help me, so I can't stress enough doing that. But then now, once I started the business as far as kind of what I would recommend is, you know, the Rolodex that I have.
Eva Norman: 46:59 So one thing that I have to tell you, this phone has 7,000 contacts right now. Yes. I know guys. If you can too. All right. 7,000 and I'm not kidding you. And so I have organized it all beautifully. So I mean, anyone that I need, I literally put a profile together in their context. I labeled them based on her state, they're like their profession and how they can potentially help me. And so that has been huge. So because I mean, I go to so many conferences all over the country. I meet so many people and I'll just do that for PT. I do it for other professions that has been my saving grace. I've been able to find quality staff as a result. I've been introduced to, you know, perhaps, you know, corporations that I wouldn't normally have conversations with thanks to those connections.
Eva Norman: 47:51 And so it's almost like, I mean, that's probably been the easiest marketing that I've had. And so, and it's amazing how I'll call up someone five years after the fact that I met them and they'll just remember just based on the little conversation that I wrote, like a little, you know, the little notes that I had. They're like, Oh yeah, I do remember you. You had that cash based business in Minnesota. How's that going? I'm like, Oh my gosh, you do remember me? And so, it's great cause then we'll jump into the conversation and suddenly we're doing business together. So that has helped a lot. And as a matter of fact, sometimes they become even clients themselves. And so, yeah, developing your Rolodex but really organizing it well so that you don't forget those conversations. Use that notes section and write down what that conversation entailed, how you think that person could help you in the future or today, that kind of thing.
Eva Norman: 48:41 So that has helped. The honest thing I have to say to, you know, I'll put in a little plug cause as far as the marketing, you probably want to know too, you know, we don't do a whole lot. I'd have to say our website is one of the main things. But the other thing is, I joined BNI about five years ago. I don't know if you've heard of it. It's business network. At the time, I was the only physical therapist I've aligned to the United Minnesota, which I was really surprised cause when I read kind of what you know I was doing for other PTs across the country, I thought, well this is really hard to believe. And now of course there are more of, it's interesting how a lot of private practice section members have joined because I've also shared this with others.
Eva Norman: 49:25 And that has also been a great network of individuals kind of outside of my profession, but be able to connect to like other dieticians, other massage therapists and have been able to also, get business that way and just develop those relationships. So I guess what I'm trying to say is don't be afraid to like join like, you know, organizations like that or the rotary club, things like that. Potentially you can develop relationships outside of your usual comfort zone to meet, you know, people out there that can connect you to perhaps people that can afford your business or connect you to those that do. So. Yeah. So I would say that that would be huge. And I wish someone would've told me that like until you know, two years my business that I started.
Karen Litzy: 50:09 I mean what great advice and you know, what's the saying like your net worth is your network or your network makes up your net worth or something to that effect. And, that's essentially what, like you said, developing this Rolodex. I love the tips on adding notes into that. I'm going to remember that cause I don't do that and it's a great idea. A friend of mine that I used to play softball with asked me to join his BNI, which I think he's like doing a presentation in a couple of weeks. I'm going to try and catch it, but all amazing advice. And you know, I wanna thank you for being so open and honest about your story. I did not know any of that and that was very, gosh, I can't believe it if I'm being honest what an amazing journey you've had. And especially like, you'd never know it being as every time I see you at a conference, you're out dancing till two in the morning. So how is this possible?
Eva Norman: 51:18 Oh, he's asked me like where does that come from? I'm like, well there's a story behind it. So yeah, I mean I deeply love it and I owe my life to it. So I mean I really can say that I owe my life to physical therapy.
Karen Litzy: 51:28 Oh, what an amazing story. And the practice is great now. Where can people find more information about you and about the practice?
Eva Norman: 51:37 Absolutely. So our website is a great place. Liveyourlifept.com. But we're also on all the various social media facebook, Twitter, Pinterest, Instagram, LinkedIn, YouTube, well, a lot of different forms of social media. Let me think if anything else. No. And, and our website too, we actually have a weekly blog. And if there's anyone out there, by the way, that wants to be a guest blogger, please reach out to us. We're always looking for people to be a guest blogger for us, so we'd love that.
Karen Litzy: 52:18 Awesome. And, you know, just for everyone listening, if you go to podcast.healthywealthysmart.com under this episode, we'll have all the links to the website and all the various social media handles and things like that. So, one click, we'll get you to live your life PT, to learn a little bit more about the model and hopefully more PTs can kind of step into this world. And now I feel like I have such a better understanding about what you do and so much more appreciation for what you're doing in Minnesota. I think it's great. So thanks so much, Eva, for coming on.
Eva Norman: 52:56 Karen, thanks for having me.
Karen Litzy: 52:57 And everyone, thank you so much for listening. Have a great couple of days and stay healthy, wealthy, and smart.
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