The P.T. Entrepreneur Podcast

Episode Summary Cash-based clinics live and die by clear communication, confidence, and value. In this episode, Doc Danny breaks down four red flags that your staff clinician has a money mindset problem and how it quietly crushes conversions, plan-of-care adherence, retention, and clinic revenue. In This Episode, You'll Learn Why money mindset issues are common in healthcare and how they show up in cash-based care How staff clinicians unknowingly make affordability decisions for patients The damage caused by apologizing for pricing and losing authority Why downgrading plans without clinical justification creates hidden revenue loss and burnout How "made-up stories" about a patient's finances sabotage recommendations and outcomes What to coach your staff on so they sell clinically appropriate plans with confidence The 4 Signs Your Staff Clinician Has a Money Mindset Problem They decide what a patient can afford instead of what the patient needs. Making assumptions based on someone's job, car, or appearance leads to under-prescribing care and poor outcomes. Start with the diagnosis and prognosis, then let the patient decide. They apologize for pricing. If your clinician says "I know this is expensive," they've already surrendered authority. Your pricing should feel normal because the value is real. Confidence transfers. They downgrade plans without clinical justification. Selling a smaller package and stretching it out usually means more unpaid work between visits, slower progress, lower clinic revenue, and higher clinician burnout. Recommend the right plan first. They create stories about a patient's finances. "They have three kids, money must be tight" is not clinical reasoning. You don't know a patient's priorities, household income, or what they value most. Technology Spotlight Want your clinicians fully present with patients instead of clicking through notes? Try Claire free for 7 days and see how an AI scribe built for physical therapists can reduce documentation time and improve the patient experience. Key Takeaway Your clinician's job is to prescribe the plan that matches the diagnosis and prognosis, not to pre-negotiate on the patient's behalf. When staff confidence rises, conversions rise, retention rises, and the whole clinic scales faster. Free Resource Want to go from part-time to full-time in your cash practice with a clear plan? Join the free 5-Day Challenge. Connect Physical Therapy Biz PT Entrepreneur Podcast

The $250,000 Asset Sitting in Your Clinic Right Now Most clinic owners work nonstop to bring in new patients while completely ignoring the most valuable asset they already have. Their past patients. In this episode of the PT Entrepreneur Podcast, Danny explains how past clients can quietly represent hundreds of thousands of dollars in recurring revenue and why most clinics never tap into it. In This Episode, You'll Learn: Why recurring revenue is the most valuable dollar in your clinic How past patients can generate predictable, stable income The math behind a $250,000 recurring revenue opportunity How one clinic built a six-figure program without ads What to offer past patients so they actually come back Why Past Patients Are Your Hidden Asset Most clinics have seen hundreds or even thousands of patients over the years. Many of those patients had great outcomes, trust the providers, and would happily return if given the right reason. Yet most clinics never follow up unless someone gets injured again. The Power of Recurring Revenue Recurring revenue creates stability. It allows owners to plan staffing, manage overhead, and grow without constant stress. Unlike the referral-eval-discharge model pushed by insurance, cash-based clinics can design ongoing services that fit patient needs and provider strengths. A Real-World Example Danny shares how one clinic launched a small group training and movement program by reaching out only to past patients. The first cohort filled immediately. A second group followed shortly after. No ads. No cold outreach. That single program now generates between $200,000 and $250,000 in gross revenue for one clinic, with members staying an average of nearly three years. Why This Works Past patients already trust you They know your quality of care You understand their history and goals They are far easier to re-engage than new leads What You Can Offer Recurring services do not have to be complex. They might include: Small group training or movement classes Monthly check-ins or tune-ups Ongoing strength, mobility, or longevity programs Remote coaching or programming The key is matching what you are good at with what your patients actually want. Create the Time to Think Strategically Many owners never build these programs because they are buried in documentation and admin work. Claire helps remove that burden so you can focus on patients and business growth. Try Claire free for 7 days Next Steps Review your past patient list Identify patients who had strong outcomes Test one simple recurring offer Start with direct outreach before ads If you are working toward going full time in your own practice, PT Biz offers a free Part Time to Full Time 5-Day Challenge. Sign up here: https://physicaltherapybiz.com/challenge

How Big Clinical Months Can Quietly Wreck Your Cash Flow Big months feel like a win. More patients, more prepaid packages, more cash hitting the account. But if you do not understand how to manage that cash, those same big months can put you in a financial bind later in the year. In this episode of the PT Entrepreneur Podcast, Danny breaks down why prepaid revenue creates false confidence, how owners accidentally drain their reserves, and the simple rule that keeps your clinic financially stable. In This Episode, You'll Learn: Why prepaid services are not the same thing as earned revenue How reactivation campaigns can create future cash flow problems The most common mistake owners make after a big revenue month Why your clinic can look busy but feel broke The minimum cash buffer every clinic should hold The Problem With Big Revenue Spikes Danny walks through a common scenario. A clinic normally doing $20,000 per month runs a strong reactivation campaign or sees a surge in new patients. That month jumps to $50,000, much of it prepaid. On paper, it looks like massive growth. In reality, much of that cash represents services that have not been delivered yet. Why Owners Get Burned Later The mistake happens when owners take large distributions during those spike months. As patients return to use prepaid visits, monthly collections drop. The clinic suddenly looks like it is underperforming, even though the schedule is full. Danny shares that he made this exact mistake early on and had to move personal money back into the business to stabilize cash flow. The Rule That Fixes This Before distributing extra cash, clinics should hold at least three months of overhead in the business account. If your overhead is $12,000 per month, that means keeping $36,000 in cash on hand. Some owners temporarily hold even more after large prepaid months until things normalize. Prepaid Does Not Mean Earned The mindset shift is simple but critical. Prepaid revenue is not truly earned until the visits happen. When you treat prepaid cash like future obligations instead of profit, cash flow becomes predictable instead of stressful. Why Time and Clarity Matter Cash flow mistakes often come from overwhelm. When owners are buried in documentation and admin work, there is no space to think strategically. Claire helps remove that burden so you can stay present with patients and actually manage your business. Try Claire free for 7 days Next Steps Review your last big month and identify prepaid revenue Calculate three months of overhead and protect that cash Stop tying distributions to single-month spikes Build systems that create clarity instead of chaos If you are still working toward going full time in your own clinic, PT Biz offers a free Part Time to Full Time 5-Day Challenge to help you build a clear plan. Sign up here: https://physicaltherapybiz.com/challenge

The 80/20 Principle of Running a Cash-Based PT Clinic In this episode of the PT Entrepreneur Podcast, Dr. Danny Matta breaks down the 80/20 principle for cash-based clinic owners and simplifies what you should track if you want to grow past yourself. Instead of obsessing over dozens of metrics, Danny argues there are three "dollar productive" KPIs that drive almost all clinic growth. He also explains why provider schedules either snowball fast or stall for a year and how to shorten that ramp from 12+ months to around six months with the right focus. In This Episode, You'll Learn: How Claire can save staff clinicians hours each week and translate that time into meaningful revenue What the 80/20 principle means inside a cash-based clinic The concept of "dollar productive activities" and why it matters The three KPIs Danny thinks drive the majority of clinic growth Why the owner should usually handle discovery calls during growth phases Benchmarks for conversion rates at different stages of scale Why recurring services are the "sneaky" variable that stabilizes schedules How to get a new provider productive faster so clinic growth compounds Claire: Turn Saved Time Into Revenue Without Burning Out Your Team Danny opens with a simple math breakdown clinic owners can understand quickly. Time is valuable, for you and for your staff clinicians. PT Biz has found that Claire, their AI scribe, saves staff clinicians about six hours per week on average. Even if you only reclaim half of that time and convert it into patient care, that is roughly three additional one-hour visits per week per clinician. Example Danny gives: 3 extra visits per week $200 average visit rate $600 more per week per clinician Roughly $30,000 per year in additional revenue per clinician The point is not to overload your team. The point is to use technology to remove the documentation burden so you can increase capacity without increasing burnout. Try Claire free for 7 days: https://meetclaire.ai The 80/20 Principle in a Cash Practice The 80/20 principle is the idea that 20% of your actions lead to 80% of your results. Danny applies this directly to clinic growth. When your clinic is small, it is easy to get busy doing "everything" and tracking a long list of numbers. The problem is most of those activities do not move the business. Instead, Danny recommends narrowing your focus to the most "dollar productive" activities. In other words, the actions and metrics that actually drive revenue and schedule utilization. The Goal: Get a Provider Productive Fast Danny frames the big objective clearly. You want to get your own schedule full enough to hire someone. Then you want any provider you hire to get productive as fast as possible. In PT Biz's world, once a provider reaches roughly 80 to 90 visits per month, it tends to snowball into 100+ pretty quickly. But getting to that point can take some clinics over a year. If you can shorten that ramp to six months, your growth compounds. In a year, you might be able to hire two people instead of one, because each provider becomes profitable faster. The Three Dollar-Productive KPIs Danny says there are three key metrics that drive the majority of growth in a cash-based clinic. Each one represents a drop-off point that can either accelerate growth or quietly crush it. 1) New Patient Volume and Discovery Call Conversion Many owners only track "how many evals we have." Danny says you need to go one step back and track conversion from lead to evaluation. There is often a major drop-off between someone becoming a lead and actually booking an evaluation. This is usually happening on discovery calls. Benchmarks Danny shares: During growth, aim for 8 to 10 new patients per provider per month Once stable, new patient volume can drop closer to 5 per month Discovery call to eval conversion should be 70%+ He also makes a strong recommendation: during growth phases, the owner should handle discovery calls. Why? In many clinics, admins convert around 45% to 50%. Owners often convert 80% to 90% because they carry authority and can handle objections better. Danny gives an example: 20 discovery calls at 50% conversion = 10 evals 20 discovery calls at 80% conversion = 16 evals That gap can be the difference between a provider staying empty and a provider getting busy quickly. He also points out that owners sometimes resist this because it feels like a step backward, but the time requirement is smaller than most people assume. If you have 20 calls at 20 minutes each, that is under 10 hours per month and it can dramatically impact growth. 2) Evaluation to Plan of Care Conversion The second KPI is how many evaluations convert into a plan of care. When people do not commit to a plan of care, Danny says many still come back a few times, often around three visits, until symptoms improve and then they disappear. That creates unpredictable revenue and inconsistent schedules. Plan-of-care conversion makes volume and revenue more predictable. Benchmarks Danny shares: Owner: 70% conversion from eval to plan of care Staff providers: 60% conversion is a strong benchmark at scale He emphasizes that this requires quality control and training. Staff clinicians need to be comfortable with diagnosis, prognosis, and presenting a clear plan. Otherwise close rates drift and schedules stall. 3) Recurring Services After Plan of Care Danny calls this the sneaky variable that people forget, but it can make the biggest difference in schedule stability. Hiring a clinician is usually a net negative for the business at first. You are paying salary, taxes, and benefits while they are still ramping up. What stabilizes and compounds a provider schedule is recurring volume. The goal is that roughly 40% of plan-of-care patients transition into some type of recurring service after discharge. Why this matters: Recurring visits fill a predictable chunk of the schedule New patient volume no longer has to carry the whole load Providers get to work with people they enjoy long term It is mentally easier than constant evaluations Danny also explains why this is often hard for staff clinicians. They may feel uncomfortable "selling" ongoing support because they never did it in insurance clinics They may not know what to do clinically once a plan of care ends So this requires two things: education on the clinical delivery of recurring services and training on how to present it confidently. Put It Together: How to Grow Faster Without Tracking Everything Danny's bigger point is that clinic owners often get lost in too many tasks and too many numbers. If you simplify down to these three KPIs and train your team around them, your odds of building provider schedules faster go up dramatically: Discovery call conversion (lead to eval) Eval to plan-of-care conversion Plan-of-care to recurring conversion When those are strong, growth compounds. You hire faster, providers get productive faster, and you get to choose what you want the clinic to become instead of being stuck trying to "just get busy." Resources Mentioned Try Claire free for 7 days: https://meetclaire.ai Talk with a PT Biz advisor: https://vip.physicaltherapybiz.com/discovery-call Join the free Part Time to Full Time 5-Day Challenge: https://physicaltherapybiz.com/challenge

Longevity, Cash PT, and Skating Where the Puck Is Going In this episode of the PT Entrepreneur Podcast, Doc Danny talks about why he keeps coming back to one big theme: longevity. He looks at how the market around proactive health, functional medicine, and long-term performance is exploding and why cash-based clinics are perfectly positioned to play a major role. If you want to move beyond "fix the injury and discharge" and build an ongoing longevity offer, this episode lays out the opportunity and the mindset behind it. In This Episode, You'll Learn: Why patient experience is a competitive edge in cash-based practices How Claire gives you an operational advantage your patients can actually feel Why Danny has always tried to "skate where the puck is going" in healthcare How cash-based PT went from rare to common in a decade Why functional medicine and longevity clinics are booming The role PTs can play as movement-focused, accountability-driven "quarterbacks" How one training partner's transformation turned into a walking case study Why generational health change makes this work bigger than a single patient Ways to start building or partnering into a longevity offer inside your clinic Claire: The Patient-Experience Edge in a Cash Practice Danny opens by talking about what really matters in a cash-based clinic: patient experience. When people are paying out of pocket, they notice everything. He makes a simple comparison: While your competitors step out mid-session to catch up on notes, you stay fully engaged. While they stay late at the clinic finishing documentation, you are following up with patients and planning their next visits. That is the competitive edge Claire gives you. Claire is PT Biz's AI scribe, trained specifically for physical therapists. It handles your documentation instantly in the background, so your time and attention stay on your patient, not on your EMR. The result: Better in-room experience Better retention and follow-up Smoother, more efficient operations Try Claire free for 7 days: https://meetclaire.ai Skating Where the Puck Is Going Danny has always tried to pay attention to where health and wellness are headed, not just where they are today. Back in 2014, when he and his wife opened Athlete's Potential in Atlanta, cash-based PT clinics were rare. He only knew of one other in the city, but he saw more and more of them popping up on the West Coast, especially in California. That was his signal that a trend was forming. Fast forward more than a decade and there are now dozens of cash-based clinics in Atlanta alone. Many of them are true businesses with teams, multiple locations, and the kind of systems that support seven-figure revenue and even sales to private equity or hospital groups. That bet — skating to where the puck was going — paid off. The Next Wave: Longevity and Proactive Health Now, Danny sees a similar wave building around longevity and proactive healthcare. He shares the story of a training partner he has worked out with for the past couple of years. Together they have tracked: Blood panels year over year Body composition with tools like InBody Sleep and recovery data using wearables like Whoop The changes in that friend's biomarkers, physical capacity, and day-to-day energy have been dramatic. Friends who have known him for years almost do not recognize how much healthier and more capable he is. That kind of transformation is exactly what more people are starting to want. And the broader market is responding. Functional Medicine and Longevity Are Booming Danny points to the rapid growth of functional medicine, lifestyle medicine, and longevity-focused services as a sign this is not a fad. He has seen: Naturopathic and functional medicine clinics expanding quickly Providers leaving hospital systems to start proactive, integrative practices High-end gyms and programs charging tens of thousands per year for bundled health, testing, training, and recovery When he first looked for a functional medicine provider in Atlanta, there was one very expensive option. Today there are multiple. Even family members of his who were deeply rooted in traditional medical systems have shifted into functional and lifestyle medicine because they want to help people earlier, not just when they show up critically ill. The PT's Role in the Longevity Ecosystem Danny is clear: he is not saying physical therapists should try to become functional medicine doctors. Instead, he sees a natural lane where PTs can win: Movement and musculoskeletal health experts Accountability partners who help people actually implement changes Educators who can translate research and trends into safe, practical steps He has already tested this in small ways at Athlete's Potential — reviewing blood panels, talking through sleep data, adjusting training, and updating exercise programs over months and years as patients move from "out of pain" to "performing and staying healthy." For some people, that relationship has lasted for years, shifting from acute rehab to long-term physical and lifestyle coaching. Blue Ocean: Ongoing Longevity Coaching for the Right People Danny describes this longevity space as a "blue ocean" for the right clinics: There are more and more people who want proactive help with their health. There are relatively few trustworthy, movement-focused providers offering it in a structured way. He draws a line between evidence-based functional and lifestyle medicine providers and more fringe offerings that are heavy on hype and light on science. A clinical background, understanding of research, and experience with musculoskeletal care give PTs a strong foundation to cut through the noise for their patients. And you do not have to do it alone. You can: Build your own longevity-style continuity offer inside your clinic, or Partner with functional medicine or lifestyle medicine providers and stay focused on movement, strength, and physical capacity. Generational Health Change One of the most powerful parts of Danny's story is the ripple effect he has seen in his training partner's life. By changing his own habits — training, sleep, stress management, nutrition — that friend has also influenced his entire family and friend group. Kids see what their parents do and assume it is normal. Friends see what someone has done for their health and start asking questions. Danny calls this "generational health change." You are not just helping one person feel better. You are changing what feels normal for the people around them, including their kids. From "Your Knee Feels Better" to "What Do You Want Life to Look Like at 80?" So what does this look like in a practical way inside your clinic? Danny suggests starting with a simple shift in conversation once an injury is under control: Talk about how long they want to be functional and independent. Ask what they want life to look like in their 70s and 80s. Use the older adults you have seen on both ends of the spectrum as examples. From there, you can start to build ongoing support — programming, check-ins, movement testing, and education — that helps them move toward that long-term vision instead of just away from short-term pain. Is Longevity a Fit for Your Clinic? Danny is not saying every clinic has to add a longevity offer. If you like what you are doing now and your business is healthy, that is okay. But he does believe this is where a big part of the market is heading. People are more aware, more curious, and more willing to invest in staying capable longer. For clinics that want to play in that space, now is the time to start paying attention and experimenting. Resources Mentioned Try Claire free for 7 days: https://meetclaire.ai Talk with a PT Biz advisor about your clinic and offers: https://vip.physicaltherapybiz.com/discovery-call Join the free PT Biz Part Time to Full Time 5-Day Challenge: https://physicaltherapybiz.com/challenge

The One Thing Filter: How to Make Better Decisions as Your Clinic Grows In this episode of the PT Entrepreneur Podcast, Doc Danny shares a simple but powerful idea for clinic owners: pick one core outcome your business exists to create and use it as a filter for every major decision. As your team grows, choices get more complex — what to say yes to, what to ignore, who to hire, what projects to start. Danny breaks down how to choose your "one thing," why money has to be part of it, and how aligning your team around that filter makes leadership easier and your business more stable. In This Episode, You'll Learn: Why documentation is the #1 satisfaction killer for many clinicians — and how Claire can remove most of it Why early-stage goals are simple (replace your income) and what changes once you get past survival The "what race are you running?" analogy and how it exposes mismatched decisions How to decide what you actually want your business to look like long term Why "no money, no mission" matters, even for mission-driven clinic owners How PT Biz landed on its own "one thing": helping clients make more money in their clinics How to use a single filter to decide on hires, con-ed, software, space, and new projects How to get your whole team making decisions through the same lens instead of waiting on you Claire: Stop Letting Notes Crush Your Day Danny opens by talking about satisfaction surveys in our profession. Over and over, clinicians say the same thing: they hate writing notes. It is the part of the day that makes them want to quit, and it is the last thing they want to do when they get home. Claire is the AI scribe PT Biz built specifically for physical therapists. Think of it like having a meticulous student in the corner, capturing the details and drafting your notes so you can stay locked in on your patient. Trained on physical therapy workflows and language Drafts notes for you so you are not catching up after hours Helps you remove most of your documentation time and get your evenings back Try Claire free for 7 days: https://meetclaire.ai From Survival Mode to Strategy Early on, business decisions are simple. Your goal is clear: replace your job income so you can safely support yourself and your family. You are willing to work long hours and say yes to almost anything that moves revenue in the right direction. Once that need is met, the decisions get harder. Do you stay small? Do you grow? How big? What kind of life are you actually trying to build around this business? Danny points out that most owners never slow down to answer those questions. They are "jumping out of the plane and building the parachute on the way down," chasing whatever looks like opportunity without checking if it fits the life they want. What Race Are You Actually Running? To explain the problem, Danny uses an endurance analogy. Training for a 5k is very different from training for a marathon. Training for a 100-mile race is different again — in volume, intensity, nutrition, and time. A lot of owners, he says, are making decisions like they are running a 5k — short-term, fast payoff, quick bursts — when in reality they are trying to run a very long, very hard race. Their decisions and their true goals do not match. Get Clear on the Life You Want First Before you can pick a filter, you have to be honest about what you actually want. What do you want your business to look like 5–10 years from now? How big does it really need to be to support the life you want? What matters more to you: growth, time freedom, leadership, selling someday, or staying clinical? Danny suggests sitting down by yourself, and with your spouse or family if you have one, and talking through the kind of life you are trying to build. You might realize you do not need as big of a practice as you assumed — or that you are thinking too small for what you actually want. No Money, No Mission As mission-driven as PTs are, money still matters. Danny shares a lesson from when his wife ran a military nonprofit in Hawaii. Her boss used to repeat a simple phrase: "No money, no mission." If there is no revenue, there is no staff, no programs, no impact. Your clinic is a for-profit business, but the same rule applies. Without healthy revenue, you: Cannot provide for yourself or your family safely Cannot create good jobs with fair pay and benefits Cannot support your community or give back meaningfully Money is simply an exchange of value and trust. You have to get comfortable with it if you want your mission to survive. PT Biz's "One Thing" Filter At a recent planning retreat, the PT Biz leadership team spent hours wrestling with a single question: "What is the most important thing we do for our clients?" They help people with work–life balance, health, relationships, and dealing with the emotional weight of entrepreneurship. Those things matter. But when they drilled down to the one outcome everything else depends on, the answer was simple: The purpose of PT Biz is to help clients make more money in their clinics. When their clients make more money: They can hire better, pay better, and create low-volume environments They can offer true lateral transfers from hospital or corporate jobs They can reduce burnout and build careers that last So now every major decision runs through one filter: "Does this help our clients make more money in their clinics?" How a Single Filter Guides Decisions Once that filter was clear, decisions got easier. Examples Danny gives: Hiring: Does this role help clients grow their revenue or improve their business directly? If not, it is probably a no. Education and con-ed: Does this topic help clients run better businesses and increase revenue? If not, it is lower priority. Events and guest speakers: Do they add to clients' ability to build stronger practices, not just feel inspired? New resources and tools: Do they point back to revenue-producing activities or critical business skills? Instead of chasing every interesting idea, the team now says no to anything that does not connect back to helping clients make more money. Give Your Team the Same Decision Filter As your clinic grows, you cannot be the only person making decisions. Front-desk staff, clinicians, and leaders all have to make calls every day. If they know the filter, they can ask themselves: Does this software, course, hire, or project support our "one thing"? If not, why are we spending time or money on it? When they make a call that is off, you can go back to the filter and see if it is a training gap or a culture issue. Over time, everyone gets better at choosing in the same direction without you micromanaging every move. Your Challenge: Choose Your "One Thing" Danny closes with a challenge for clinic owners: Decide on the single most important outcome your business exists to create. Make sure it is big enough to support the life you want and honest enough to include money. Share it with your team and use it as part of your weekly meetings and training. Run every major decision through that filter so saying "no" and "yes" gets simpler. When everyone knows the race you are running and the "one thing" that matters most, your decisions get clearer, your team gets more aligned, and your business is far more likely to move in the direction you actually want. Resources Mentioned Try Claire free for 7 days: https://meetclaire.ai Book a call with a PT Biz advisor: https://vip.physicaltherapybiz.com/discovery-call Join the free Part Time to Full Time 5-Day Challenge: https://physicaltherapybiz.com/challenge

What To Do With a Frustrating Employee In Your Clinic In this episode, Doc Danny breaks down one of the hardest parts of owning a clinic: dealing with a talented but frustrating employee. You know the type. Great with patients, solid outcomes, but sloppy with systems, notes, and follow through. Danny walks through the three real options you have, why "letting it slide" destroys culture, and how to use a performance improvement plan to either turn things around or coach someone out. In This Episode, You'll Learn: The classic pattern of the friendly, high-output clinician who struggles with systems Why tolerating mediocrity from one person lowers the standard for your entire team The three options you have with a frustrating employee (and the one most owners avoid) How to build and run a simple, effective performance improvement plan (PIP) Why leadership and standards matter more than any one hire How "coaching people out" protects your culture and your A-players Questions to ask yourself about your onboarding, training, and systems Claire: Get Your Attention Back on Patients Danny opens with a reminder of how fast documentation can pull your attention away from patients. As PTs, we pride ourselves on building rapport and relationships, but it is hard to do that when you spend half the session staring at a laptop. Claire, the AI scribe built specifically for physical therapists, lets you give patients 100% of your attention while it writes your notes for you. No more "split attention" between EMR and patient Better engagement and outcomes because you are actually present Notes drafted for you based on the session so you can review and finalize Try Claire free for 7 days: https://meetclaire.ai The Talented but Frustrating Employee Danny describes a very familiar pattern in service businesses. You hire someone you like. They are a good culture fit. Patients love them. Outcomes are strong. But behind the scenes, they: Drag their feet on notes and documentation Ignore or half-follow systems and processes Show up a little late, miss small details, or respond slowly to emails and Slack They are not a disaster. They are not a clear liability. But they are not meeting the standard either. That gray area is exactly where most owners get stuck. First, Own Your Part as the Owner Before you blame the employee, Danny challenges you to look in the mirror. Have you: Actually trained them on your EMR, project management tools, and communication systems? Explained why those systems matter (data, tracking, meetings, outcomes, marketing)? Given them clear expectations, examples of "done right," and time to practice? Most owners are busy and rush onboarding. They throw people into the deep end with a few screen-share videos and hope they figure it out. Then they get mad when the systems are not followed. Your Three Options With a Frustrating Employee Once you are honest about your own role, you really have three options: Let it go. Accept that this person is just this way. They are good with patients, weak with systems, and you live with it. Let them go. Fire them for not following processes and creating extra work for others. Create a performance improvement plan. Sit down, define what needs to change, and track progress over a set period. Danny explains why the first option is the most dangerous. When you tolerate one person ignoring standards, everyone else sees it. Your A-players start to wonder why they are working so hard. Support staff quietly resent the extra work. The real standard becomes "we say we care about systems, but we do not enforce them." How to Build a Performance Improvement Plan The go-to approach in Danny's companies is a structured performance improvement plan (PIP). It usually looks like this: Define the specific problems (late notes, missing CRM updates, slow responses, etc.). Clarify why each behavior matters to the business and the team. Decide what is truly necessary for the role and remove anything redundant. Set clear, measurable expectations for the next 4–6 weeks. Meet weekly to review progress, answer questions, and coach them on better workflows. Make it clear this is a non-negotiable standard if they want to keep the role. This is not about punishment. It is about support, clarity, and accountability. The PIP gives the employee a real chance to succeed with your help. What Usually Happens Next Once you run a real PIP, you tend to see one of two outcomes: They turn the corner. With training and clear expectations, they improve their systems work, become more efficient, and turn into a strong long-term hire. They opt out. They resist change, make excuses, and realize this is not a place where they can do whatever they want. They often resign on their own. Either way, you win. You either save a good clinician by giving them structure or you protect your culture by making it clear that standards are real. Leadership, Standards, and A-Players Danny points out that your best people are always watching how you handle situations like this. A-players want: Clear standards and consistency Leaders who follow through, not just talk about culture Teammates who pull their own weight When you avoid hard conversations and let someone slide, your A-players lose respect and start looking elsewhere. When you hold the line, they respect you more and see your clinic as a place worth investing their energy. The Hard Work of Real Leadership Leading people is often the limiting factor in whether a clinic ever scales. It is not manual skills. It is not marketing hacks. It is your willingness to: Have tough, honest conversations Take responsibility for training and support Set standards and enforce them consistently Spend time coaching people, even when you feel "time poor" That work is uncomfortable, but it is the difference between a team that drifts into mediocrity and one that grows with you for years. Want Help Navigating This as a Clinic Owner? If you are facing a frustrating employee, wondering how to hold standards, or trying to grow from being the only producer to running a real team, Danny and the PT Biz advisors can help you work through it. Talk through your situation with an advisor: https://vip.physicaltherapybiz.com/discovery-call Try Claire free to buy back documentation time: https://meetclaire.ai Still part time and trying to go full time in your own practice? Join the free 5-Day Part Time to Full Time Challenge here: https://physicaltherapybiz.com/challenge

How to Turn Patients into Raving Fans (and Referral Machines) In this episode of the PT Entrepreneur Podcast, Doc Danny breaks down why most clinics are stuck in "purgatory" with word of mouth and what separates average clinics from the ones patients can't stop talking about. Using a great chicken joint and a mediocre Italian restaurant as examples, he shows you how clients really think about your business and what has to change if you want more organic referrals in 2026. In This Episode, You'll Learn: Why saving clinician time with an AI scribe like Claire can quietly add $30,000 in revenue per staff PT per year The two levers that drive referrals in any service business: outcomes and experience How a chain "hot chicken" spot crushed a local restaurant on basic execution Why "pretty good" is the most dangerous place for your clinic to live What a 9–10 Net Promoter Score really looks like inside a cash practice How your space, punctuality, and communication shape patient trust Why referrals jumped when Danny moved from a subleased gym corner to a standalone space A simple way to mystery shop your own clinic and see what patients see Claire: Freeing Up Time and Unlocking Revenue Danny opens by talking about Claire, the AI scribe built for cash-based clinics. On average, Claire is saving staff clinicians six hours a week on documentation. Even if you only recapture half of that time for patient care, that is three extra one-hour visits per clinician per week. 3 extra visits per week at $200 per visit = $600 per week Roughly $30,000 in additional annual revenue per staff clinician And it all comes from taking notes off their plate and putting that time back into patient care. Try Claire free for 7 days: https://meetclaire.ai Two Restaurants, Two Very Different Referral Stories Danny shares a simple contrast to frame how referrals really work. On the same day, he took his son to Dave's Hot Chicken and later that night took his family to a new Italian restaurant near their house. Dave's Hot Chicken: Friendly staff, simple "honey hack" suggestion, clean space, food that exceeded expectations. He would happily tell people to go there. Local Italian restaurant: No clear host, missing reservation, clunky service, average food at a higher price point. He will not badmouth them, but he is not going to recommend them either. That is exactly how patients think about your clinic. They are either excited to send people, quietly neutral, or actively warning people away. Net Promoter Score and Your Clinic Danny ties this into Net Promoter Score (NPS), a simple question that predicts referrals. "On a scale of 0 to 10, how likely are you to refer a friend or family member to this clinic?" 9–10 = promoters who actively tell people about you 0–6 = detractors who may talk negatively 7–8 = passives who are neutral and mostly silent Most clinics live in the 6–8 range. Not good enough to be talked about. Not bad enough to be trashed. That is business purgatory. The Two Levers: Outcomes and Experience For a cash-based clinic, your referrals come from two places. Outcomes: Are you actually better than the average in-network option? Do people get results faster and more completely? Experience: What is it like to work with you? Space, punctuality, communication, how you follow up, how individualized things feel. If your space is a noisy gym corner or a rough sublease, you have to make up for that with flawless communication, punctuality, and outcomes. When you eventually level up into a standalone space, the experience finally matches the quality of your care. Danny saw that firsthand when his clinic moved from a subleased gym space to a standalone location. Referrals jumped. Patients openly said they were now more comfortable sending friends and family because the space matched the price and reputation. Are You "Just Okay"? Danny challenges clinic owners to be honest about where they sit. Are you truly a 9 or 10 out of 10 on outcomes and experience? Or are you a 6–8 where people say you are fine but do not talk about you proactively? He suggests a simple exercise. Have a friend or family member your staff does not recognize come through as a "mystery shopper" patient. Let them go through your entire process and give you brutally honest feedback about what felt confusing, clunky, or underwhelming. Getting Obsessive About Excellence Clinics that become referral machines look different on the inside. They: Obsess over outcomes and ongoing clinical improvement Obsess over small details in the patient journey, from first inquiry to discharge Answer quickly, follow up clearly, and stay ahead of patient questions Fix small frictions in their space and processes every month When you get this right, you build a stable referral base that cushions you from algorithm changes, ad costs, and platform shifts. You still might use marketing, but you are not desperate for it. Want a Clear Path to Go Full Time? If you are still in the early stages of leaving a job and going all in on your own cash-based practice, PT Biz runs a free Part Time to Full Time 5-Day Challenge that walks you through: Exactly how much income you need to replace How many patients you need to see and at what average visit rate Three different strategies to go from part time to full time The basic sales and marketing systems you need in place A simple one-page business plan so you can take action Join the free challenge: https://physicaltherapybiz.com/challenge

Big Ship or Small Boat: Are You in the Right Organization? In this episode of the PT Entrepreneur Podcast, Doc Danny tells a story from his time as an Army PT in Hawaii and how a denied human performance proposal, that finally got implemented 13 years later, forced him to ask a hard question. Am I on the right ship or do I need to build my own boat? If you feel boxed in by red tape, slow decisions, and limited influence, this one will hit home. In This Episode, You'll Learn: The human performance proposal Danny and a strength coach pitched to their division in 2011–2012 Why a project that would save millions and improve readiness still got shut down What a general meant when he said "the Army's a big ship and it turns really slowly" How that moment planted the seed for Danny leaving to start his own practice How to tell if you are in the wrong organization for your personality and goals Why some people thrive in big systems and others feel suffocated by them Why regret is worse than trying and failing at your own thing What to do if you suspect you need to build the job you want instead of waiting for it The Schofield Barracks Story Back in 2011–2012, Danny was the only physical therapist for an entire brigade at Schofield Barracks in Hawaii. Between him, another PT, and a shared strength coach, they were responsible for thousands of soldiers spread across multiple brigades and clinics. Injury rates were driving a constant stream of soldiers into civilian clinics and hurting deployment readiness. Danny and his strength coach friend put together a human performance proposal that would add a handful of contracted providers. The math was simple. A few hundred thousand dollars of contract help could save the Army millions and keep more soldiers ready to deploy. They took the plan to the division commander, a general who was also one of Danny's patients and very supportive of what Danny was doing clinically. Danny walked into the meeting convinced the proposal would be approved. It was denied. "The Army's a Big Ship and It Turns Really Slowly" The next day, the division commander pulled Danny aside and explained his decision. He said he liked the idea, but told him the Army is a big ship and it turns very slowly. That comment stuck. Danny remembers thinking, "If this is such an obvious win and we still can't move, do I even want to be on a ship like this?" More than a decade later, his strength coach friend called to say the division had finally launched a human performance program that looked a lot like their original proposal. "We were right. We finally won," he said. Danny laughed. It took over ten years for the ship to turn. Are You on the Right Ship? The point of the story is not just that the military moves slowly. The point is to help you ask whether you are in the right environment for how you are wired. Big organizations: Move slowly and carry layers of approval and red tape Limit how much control you have over clinical model, scheduling, and innovation Can be a great fit if you value stability, structure, and predictable paths Entrepreneurship and small clinics: Move quickly and let you act on ideas without begging for permission Give you direct control over patient experience, offers, and operations Come with more personal risk and fewer safety nets If you constantly find yourself saying "There is a better way to do this and nobody will listen," that is a sign. If you love solving problems, want to experiment, and are tired of watching your ideas die in meetings, you may not be in the right organization. Don't Wait a Decade for Someone Else to Say Yes Most physical therapists never planned to start a business. The default story is to join a big rehab system or national chain, climb the ladder to clinic director, then maybe move into regional leadership. That can be a great path for the right person. But if you feel like you are on a big ship that turns too slowly, you may need to build the job you actually want instead of hoping someone else creates it for you. Trying and failing at your own thing is almost always better than never trying and sitting with regret later. At some point, you will not have the same window to take a swing. Action Steps If You Feel "Stuck" Check your frustration. Is it about one boss or one clinic, or is it about the whole system? Write down the kind of care you wish you could deliver if nobody told you "no." Run the numbers on what it would take to replace your income in a small cash-based practice. Talk to people who have already left big systems and ask what they would do differently. Need Help Building Your Own Boat? If you suspect you are in the wrong organization and want a concrete plan to go from employed to running your own cash practice, the PT Biz Part Time to Full Time 5-Day Challenge will walk you through: Exactly how much income you need to replace How many patients you need to see and at what visit rate Three different paths to go from part time to full time The basic sales and marketing systems you will need A simple one-page business plan so you can take action Join the free challenge: https://physicaltherapybiz.com/challenge Free Your Time With Claire, the AI Scribe If your current job has you charting during sessions or staying late to finish notes, Claire can help. Claire is an AI scribe trained specifically for physical therapists that handles your documentation so you can focus fully on your patients and follow up with them instead of your EMR. Try Claire free for 7 days: https://meetclaire.ai

Four Big Lessons from 2025 for Cash-Based PT Owners In this year-end episode of the PT Entrepreneur Podcast, Dr. Danny Matta shares the four biggest lessons he learned in 2025. From a small revenue dip at PT Biz to the rise of corporate cash clinics, the longevity wave, and why happiness cannot be tied to "winning," Danny breaks down what actually matters for clinic owners who want a sustainable, meaningful business and life. In This Episode, You'll Learn: Why PT Biz saw its first year-over-year revenue decline and what actually caused it The danger of chasing brand polish while neglecting core sales and marketing fundamentals Why corporate and private-equity backed cash and hybrid clinics are coming fast How to decide if you should stay small and lifestyle-based or grow and compete Why "health is wealth" is both a mission and a major business opportunity How to think about long-term performance, longevity, and lifetime value in your clinic Why happiness cannot be tied only to hitting revenue goals or "winning" in business How gratitude, perspective, and boundaries at home change how you lead at work Lesson 1: The Year Revenue Went Backwards For the first time outside of COVID shutdowns, PT Biz saw a year-over-year decline in top-line revenue. It was not a crash, but it was the first dip in an otherwise steady climb. Going into 2025, the team made a big bet: double down on brand and visibility. That meant more clinic tours, more travel, more polished content, stronger YouTube presence, and a much more professional public-facing brand. The upside: the brand looks sharper, more consistent, and more aligned with what PT Biz actually delivers. The downside: attention and effort shifted away from core sales and marketing fundamentals that had been driving client acquisition for years. The brand got better. The KPIs that actually bring in new owners slipped. The lesson: do not starve the fundamentals to fund a big bet. Brand polish is great, but not at the expense of the boring systems that quietly keep your pipeline full. Momentum is effort multiplied by accuracy, and this year the effort was high, but the target was slightly off. Lesson 2: Corporate Cash Clinics Are Coming Regional cash and hybrid groups are already growing in multiple markets. They have strong brands, smart operators, and they are learning how to scale performance-based services across locations. As interest rates fall and borrowing becomes cheaper, larger groups and backers are going to look at cash-based PT the same way they looked at in-network PT years ago: fragmented, profitable, and ripe for consolidation. That creates a fork in the road for small clinic owners: Stay small, stay lifestyle: Keep a lean, owner-operated practice, accept your capacity ceiling, and focus on doing great work with a small team. Grow and compete: Commit to becoming a true business owner, not just a great clinician. That means learning hiring, leadership, cash flow, marketing beyond yourself, and building a place where people want to work long term. Either path can be a win. But "average" business skills will not cut it in crowded markets where well-funded competitors offer better recruiting, benefits, and systems. Lesson 3: Health Is Wealth (and Your Biggest Opportunity) There is a cultural shift happening around health and longevity. People are listening to three-hour podcasts on sleep, VO2 max, and zone 2 training. Functional medicine clinics are everywhere. High-end "longevity programs" are popping up inside luxury gyms. For movement-based, performance-focused cash practices, this is a massive opportunity. Your patients no longer just want to get out of pain. They want to stay strong, independent, and capable for as long as possible. They are looking for a guide who can help them preserve function, strength, and energy for decades, not weeks. This is where you can step in as the long-term quarterback of their health and performance. That might include: Strength and mobility programming designed for longevity Clear testing and reassessment around performance and function Coaching on sleep, recovery, lifestyle, and training hygiene Long-term continuity options and proactive care plans Done right, this dramatically increases lifetime value per client and creates deeper, more rewarding clinical relationships that match why you went into this profession to begin with. Lesson 4: Happiness Is Not Tied to "Winning" For many high achievers, revenue is the scoreboard. Hit the goal and you feel like a winner. Miss it and you feel like a loser. In past years, missing a big target would have poisoned Danny's entire year and bled into family life at home. This year, even with a small revenue decline, he is as content as he has ever been. The difference is perspective. When you zoom out, the "loss" on the scoreboard sits next to: Rebuilt personal health after knee surgery and a return to the activities he loves A stronger marriage built over nearly two decades together Healthy, growing kids who are ambitious, kind, and thriving A real sense of community and friendships at home The lesson: your mood and your identity cannot be chained to one metric inside your business. You can care deeply about your goals, push hard, and still refuse to let a missed target turn you into a miserable person for the people you love. Gratitude is not a fluffy quote. It is a practical tool. When business feels heavy, you can actively ask: what went well this year, what am I proud of, and what in my life would I never trade for a slightly bigger number on a spreadsheet? Action Steps for Clinic Owners Review the year honestly: where did effort get misdirected away from proven fundamentals? Decide which race you are running: lifestyle solo practice or growth business that competes with bigger players. Start building a true long-term health and longevity offer for your best-fit patients. Schedule time to reflect on what went right, what you learned, and what you are grateful for outside of money. Ready for Help With Your Next Step? If you want help figuring out what to focus on next and how to build a business that matches the life you actually want, set up a call with a PT Biz senior advisor. They will look at your numbers, your goals, and your current plan, then help you map out your next moves. Book a free discovery call: https://vip.physicaltherapybiz.com/discovery-call Free 5-Day Part-Time to Full-Time Challenge If you are still in the early stages and building your practice on the side, Danny's PT Biz Part Time to Full Time 5-Day Challenge will help you: Get clear on exactly how much income you need to replace Know how many people you need to see and at what visit rate Pick a path to go all in based on your current situation Learn the basic sales and marketing systems you will need Build a simple one-page business plan so you can take action Join the free challenge: https://physicaltherapybiz.com/challenge Remove Your Documentation Burden With Claire If documentation is burning you out and pulling attention away from your patients, try Claire, the AI scribe built for physical therapists. Claire listens, structures your notes, and gives you back your time so you can focus on the person in front of you. Try Claire free for 7 days: https://meetclaire.ai