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Should You Niche Your PT Clinic? The Answer Depends on This · Build Your PT Clinic with Bryan Wright, DPT

• 0:00
  SPEAKER_00: Should you niche your clinic down to one thing or provide general services to everybody?
• 0:04
  SPEAKER_00: You might have heard the answer to that many times.
• 0:07
  SPEAKER_00: Most of the time it comes to this answer of niching down because of course the riches are in the niches, right?
• 0:12
  SPEAKER_00: Every business podcast out there says some version of that.
• 0:15
  SPEAKER_00: The problem I see with that advice is perspective.
• 0:18
  SPEAKER_00: It's coming from a perspective that doesn't know you and where you're at.
• 0:22
  SPEAKER_00: It gets handed out by people who have no idea where you practice, what the people in your community need, and where you practice changes the answer completely.
• 0:30
  SPEAKER_00: So I'll give you guidelines I use and a way to figure out your own depth of that niche.
• 0:35
  SPEAKER_00: So you're not copying somebody who built her clinic in a city of 2 million while you're working in a town of 10,000.
• 0:41
  SPEAKER_00: So a quick little bit about me so you understand where I'm coming from.
• 0:45
  SPEAKER_00: I come from a rural area.
• 0:46
  SPEAKER_00: I started my first clinic in a town of about 50,000.
• 0:49
  SPEAKER_00: And I took that one physical therapy clinic and grew it into a$50 million enterprise with over 21 locations and counting, which means I've made this decision in a lot of different markets, including the smaller ones.
• 1:02
  SPEAKER_00: Where I started at 50,000, even went all the way down to about 4,000 people in a community.
• 1:07
  SPEAKER_00: So this niche question is something that I've visited many times.
• 1:11
  SPEAKER_00: And I've also watched owners make both mistakes.
• 1:14
  SPEAKER_00: Some stay so broad that nobody in their community remembers them, and others niche so far down that there aren't enough patients left to actually fill the schedule.
• 1:23
  SPEAKER_00: I believe that the virtuous center, or what I would call a right answer, sits somewhere in that virtuous center of those extremes.
• 1:30
  SPEAKER_00: And where that line falls for you comes down to usually a number most clinic owners have never really calculated.
• 1:37
  SPEAKER_00: So let's start with the principle of niching down because everything else will flow downstream from this very important decision.
• 1:44
  SPEAKER_00: Nitching down means that you're getting very specific with what your services or product is.
• 1:49
  SPEAKER_00: One of the core teachings I share often is that what we say yes to causes us to expand, and what we say no to is what creates success.
• 1:58
  SPEAKER_00: So how does that actually show up inside of a company or a clinic?
• 2:02
  SPEAKER_00: Well, say you decide to do vestibular care and pelvic floor and balance training and orthopedics and wound care and post-op and work comp because you're the best at all of them and it all pays and you can technically do it because you know a little bit about all of it.
• 2:18
  SPEAKER_00: You feel like you know a lot, but you know a little bit.
• 2:20
  SPEAKER_00: You just said yes to seven or eight things, and in saying yes to those things, you said no to ever being known for any one of them very, very specifically and very well.
• 2:28
  SPEAKER_00: The person in your community waking up with the room spinning isn't actually sitting hoping to find a clinic that does seven things well.
• 2:36
  SPEAKER_00: She just wants the vertigo place.
• 2:37
  SPEAKER_00: And in her mind, that's somebody else.
• 2:39
  SPEAKER_00: Even if you happen to be better at it than the clinic that she picks, knows that very specifically.
• 2:44
  SPEAKER_00: And that's the trade you want to think and talk about.
• 2:47
  SPEAKER_00: Saying yes to everything feels like a safe play.
• 2:50
  SPEAKER_00: And the whole time it's actually costing you quietly underneath the surface.
• 2:54
  SPEAKER_00: One thing that brings most people who don't know you through your door.
• 2:57
  SPEAKER_00: So, what is it that you get by investing in no?
• 3:00
  SPEAKER_00: You get to be the obvious choice for somebody who needs your specialty and actually desires that you have a specialty, and that makes it worth it.
• 3:07
  SPEAKER_00: And its value is actually more than every dollar of revenue you think you're giving up to turn away those patients who are not your specialty.
• 3:16
  SPEAKER_00: Being the obvious choice does things for you that no amount of hustle ever can or will.
• 3:21
  SPEAKER_00: For one, referrals flow better to you because a physician can remember one quality aspect about you.
• 3:26
  SPEAKER_00: Your team gets better faster because they see the same opportunity over and over instead of a little of everything.
• 3:32
  SPEAKER_00: Hiring can get better because good people want to work somewhere where there is quality and depth and they know that you know your niche.
• 3:40
  SPEAKER_00: And your pricing value exchange holds up well because you're the specialist and not just another option or commodity.
• 3:46
  SPEAKER_00: Commodities get washed out.
• 3:48
  SPEAKER_00: The goal here for all business owners who want to be successful is to become a category of one business.
• 3:54
  SPEAKER_00: And let me put this referral piece in actual terms that might be understandable, because the one owners feel the fastest is referrals.
• 4:01
  SPEAKER_00: A primary care doc sees at 40 patients a day.
• 4:04
  SPEAKER_00: What's she gonna remember when the patient comes to her with an orthopedic condition?
• 4:08
  SPEAKER_00: A knee, a shoulder, a hip.
• 4:09
  SPEAKER_00: She's gonna remember one thing, and that's who the specialist is, if she remembers anything at all, because she's got her own busy schedule.
• 4:15
  SPEAKER_00: So the question actually has very little to do with how good you are.
• 4:19
  SPEAKER_00: It's actually what does the referral source think about when a patient asks her where to go?
• 4:24
  SPEAKER_00: Confusing is losing, and the right level of niching can actually simplify dramatically.
• 4:29
  SPEAKER_00: That's what the know is doing for you, for your company, and for the people who refer to you.
• 4:34
  SPEAKER_00: So, how far do you take it?
• 4:35
  SPEAKER_00: Because this is where I see it go sideways.
• 4:37
  SPEAKER_00: I've seen it go sideways for me as a result of this.
• 4:40
  SPEAKER_00: How narrow you go actually depends a lot on where you practice and what your goals are.
• 4:45
  SPEAKER_00: So if you're in a city, a big city, you can go deep.
• 4:48
  SPEAKER_00: And you probably should because the market's saturated.
• 4:50
  SPEAKER_00: And being general, clinic in a big city makes you invisible, it makes you a commodity.
• 4:55
  SPEAKER_00: But in a saturated market, you have to start as a niche, sometimes just to gain the proper attention and momentum.
• 5:02
  SPEAKER_00: So if you really want to get known for something and you're in a bigger environment, it's really good to get known for something really deep.
• 5:10
  SPEAKER_00: Now take a town of 10,000 people.
• 5:12
  SPEAKER_00: I'm more familiar with this, same profession, but it's actually different mathematics for you.
• 5:16
  SPEAKER_00: If I were to niche all the way down to balance issues in a town of 10,000, that would probably be a little too niche for me.
• 5:23
  SPEAKER_00: There may not be enough of that patient demographic inside a reasonable drive to fill the schedule, no matter how good I am at that.
• 5:30
  SPEAKER_00: So, same advice can actually have two completely different outcomes.
• 5:34
  SPEAKER_00: And whatever podcast told you to niche down didn't really have an idea of your perspective of where you're at, what your goals are, and which one of those two settings you're sitting in.
• 5:43
  SPEAKER_00: So the question being asked correctly is not whether to niche.
• 5:48
  SPEAKER_00: The question is how much your market niche gets drawn from and whether that's enough to sustainably fulfill your purpose.
• 5:54
  SPEAKER_00: See, in my realm, we decided on joint spine sport.
• 5:59
  SPEAKER_00: That is an orthopedic setting, but based on the size of our communities, it was the perfect niche down.
• 6:04
  SPEAKER_00: And so if this is more the thing that you want more of, go ahead and hit subscribe.
• 6:08
  SPEAKER_00: I put one of these videos out a week for clinic owners and aspiring clinic owners.
• 6:12
  SPEAKER_00: Now, what's the part that helps owners who don't know their niche yet?
• 6:15
  SPEAKER_00: Maybe you're sitting there just like I was thinking, yeah, this is great, but I don't know what my niche is.
• 6:21
  SPEAKER_00: I get it.
• 6:21
  SPEAKER_00: I hear that actually a lot, and I don't want it to be the reason that this stalls you out.
• 6:25
  SPEAKER_00: Nitching is a sequence.
• 6:27
  SPEAKER_00: You can sit down Sunday afternoon on your weekend and make a call and live with it for the rest of your career, but there's a way to approach it to where it's not so high risk, high stake.
• 6:37
  SPEAKER_00: Sometimes you just start by saying yes to a handful of things on purpose so that you can find out where your flywheel actually is.
• 6:44
  SPEAKER_00: You're actually watching for what comes easy naturally to you because you're telling it that what your team is unusually good at and what patients are telling other people about, their friends and their family.
• 6:54
  SPEAKER_00: That whole season of gathering information is actually a great place to start.
• 6:59
  SPEAKER_00: That's where you refine from there and you iterate.
• 7:01
  SPEAKER_00: You actually get more niche as you go based on what the market is rewarding instead of what you guessed at, what you're stabbing at.
• 7:08
  SPEAKER_00: And it's one of the best ways I've seen to help you get refined into a niche.
• 7:12
  SPEAKER_00: Sometimes you go the other direction and start out as a niche from day one because your market is so crowded, there's not enough room to be general.
• 7:19
  SPEAKER_00: You would get washed out.
• 7:20
  SPEAKER_00: Both of those are okay ways to start.
• 7:22
  SPEAKER_00: And which one you're doing depends on your market and how much you already know about what your flywheel engine is.
• 7:28
  SPEAKER_00: So if you already know what you're telling it at, what flows to you, what makes you passionate, and what your team is unusually good at, you're gonna be ahead of the game.
• 7:35
  SPEAKER_00: If you don't, there's a way to get there.
• 7:36
  SPEAKER_00: What you can't do is stay broad forever and call that a strategy.
• 7:40
  SPEAKER_00: Broad is a starting position and it was not meant to be the destination.
• 7:44
  SPEAKER_00: So a general guardrail on this, because the gathering phase is the easiest place in the world to hide your talents.
• 7:51
  SPEAKER_00: Dr.
• 7:51
  SPEAKER_00: Henry Cloud has a set of laws about boundaries.
• 7:54
  SPEAKER_00: And one of them has stuck with me for years.
• 7:56
  SPEAKER_00: It is passivity is a decision wearing the costume of patients.
• 8:00
  SPEAKER_00: If you've been gathering information for four years, you stopped gathering a long time ago and you've been avoiding ever since.
• 8:06
  SPEAKER_00: So put a deadline on it.
• 8:08
  SPEAKER_00: Because when we put a deadline on it, we move things forward.
• 8:10
  SPEAKER_00: So before you commit, do the work.
• 8:12
  SPEAKER_00: Don't skip this and get away with it for long.
• 8:14
  SPEAKER_00: Find out how many people within a reasonable drive of your company actually have the problem that you want to solve.
• 8:21
  SPEAKER_00: And I don't mean roughly, I mean a real number you'd be willing to defend to a group of people that you respect.
• 8:28
  SPEAKER_00: Find out who's already serving them and how well they're doing it.
• 8:31
  SPEAKER_00: If there are, say, four clinics in your town that are saying the same thing you're about to promote, you either go deeper or it's time to pick something else that you feel that fits those criteria that we talked about.
• 8:42
  SPEAKER_00: Easy for you, talented, passionate.
• 8:44
  SPEAKER_00: Look at what already works inside your space.
• 8:46
  SPEAKER_00: Pull your numbers, see what you're already unusually good at, because there's usually a niche hiding right under your nose in the chart data.
• 8:54
  SPEAKER_00: And quite a few owners haven't really gone looking for it.
• 8:57
  SPEAKER_00: This is a great time for you to pause and think about how you can go looking for it.
• 9:00
  SPEAKER_00: And then look at whether you'd still want this same niche in say five to ten years, because you'll be doing a lot of it.
• 9:08
  SPEAKER_00: That's a feasibility check.
• 9:10
  SPEAKER_00: And it'll take you a couple of weeks, maybe even longer, but it is a whole lot cheaper than committing your building and your hiring and your entire brand and your marketing to a specialty that actually does not feed your soul and doesn't feed your company.
• 9:23
  SPEAKER_00: So here's some guidance for you.
• 9:24
  SPEAKER_00: Write down every kind of patient you currently treat, every bit of it.
• 9:29
  SPEAKER_00: Then, as you look at it in front of you, circle to one where you're honestly the best option in your area and where enough of those people live close enough to feel the schedule for what your long-term goals are.
• 9:40
  SPEAKER_00: Now think about it this way: if nothing gets circled, you're actually not ready to niche yet.
• 9:45
  SPEAKER_00: You're in the gathering phase still, and that's okay.
• 9:48
  SPEAKER_00: Stay broad on purpose for now and start tracking where your flywheel is.
• 9:51
  SPEAKER_00: That's where the no's create success, and that's what boundaries are.
• 9:55
  SPEAKER_00: It's what you're saying no to.
• 9:56
  SPEAKER_00: If something does get circled, then you have that work in front of you of saying no to the rest of what's not that.
• 10:03
  SPEAKER_00: Say no to anything that is not your specialty.
• 10:06
  SPEAKER_00: This is not something that's gonna just happen overnight.
• 10:09
  SPEAKER_00: It's a process, and that part is going to feel maybe uncomfortable.
• 10:13
  SPEAKER_00: And let me name why.
• 10:14
  SPEAKER_00: Another one of Cloud's laws is the law of evaluation.
• 10:17
  SPEAKER_00: A healthy boundary will actually disappoint people, and the discomfort isn't the same as harming somebody.
• 10:22
  SPEAKER_00: So when you stop taking a certain kind of patient, someone will be let down.
• 10:26
  SPEAKER_00: You didn't hurt them, you have to remember that.
• 10:28
  SPEAKER_00: You pointed them toward a clinic that's genuinely better for them than yours is.
• 10:32
  SPEAKER_00: So remember where we started with all this.
• 10:34
  SPEAKER_00: When you say no to what something is not for you, then you actually are creating success.
• 10:39
  SPEAKER_00: And every no you make is actually buying the right to be the obvious choice for somebody.
• 10:44
  SPEAKER_00: Dr.
• 10:44
  SPEAKER_00: Benjamin Hardy said it about as well as I've heard it ever said.
• 10:48
  SPEAKER_00: You actually don't become a leap by adding effort because you become a leap by removing the work that keeps you average.
• 10:54
  SPEAKER_00: If you take one thing with you from this whole entire video, I think that's a good one worth writing down.
• 10:59
  SPEAKER_00: Now, if that helped, feel free to subscribe so you don't miss the next one.
• 11:02
  SPEAKER_00: I want you to watch this one next.
• 11:04
  SPEAKER_00: Picking the one thing only pays off if the people who need it can actually find you saying that thing that you're niching down to.
• 11:13
  SPEAKER_00: And quite a few clinic owners are losing that fight to about 18,000 louder voices.
• 11:19
  SPEAKER_00: I am breaking down that whole problem right here.
• 11:21
  SPEAKER_00: So you don't grow by being available for everything.
• 11:25
  SPEAKER_00: You grow by being the undeniable answer for somebody.
• 11:28
  SPEAKER_00: So go pick your somebody, and I'll see you in the next one.