Latest / Build Your PT Clinic with Bryan Wright, DPT / You Must Become a CEO to Build a $10M Practice

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You Must Become a CEO to Build a $10M Practice · Build Your PT Clinic with Bryan Wright, DPT

• 0:00
  SPEAKER_00: One of the hardest transitions for a physical therapist who owns a practice or wants to own a practice is realizing that at some point being great as a physical therapist is no longer the most important job you have.
• 0:10
  SPEAKER_00: That's something I've had to learn, and it's difficult because you spent years becoming good at it.
• 0:15
  SPEAKER_00: You went to school for it, you treated thousands of patients, you built relationships in your community and it's what you know yourself as.
• 0:22
  SPEAKER_00: And if you've been successful, there's a good chance you're still one of the people patients ask for and you're the one they most ask for.
• 0:29
  SPEAKER_00: So your team's probably coming to you also if you're good to decide when they don't know what to do.
• 0:34
  SPEAKER_00: You're the person that they go to.
• 0:36
  SPEAKER_00: And all of that is what helped you to build the practice that you own.
• 0:39
  SPEAKER_00: But if you want that practice to eventually become a company that doesn't require you to be involved in everything, then at some point your job has to transition.
• 0:48
  SPEAKER_00: I'm Brian Wright.
• 0:49
  SPEAKER_00: I'm a doctor of physical therapy by vocation.
• 0:51
  SPEAKER_00: And I took one physical therapy clinic and grew it into an e-figure company with 21 locations and growing.
• 0:57
  SPEAKER_00: And one of the things I've learned through that process is that there is a very real transition you have to make from being the practitioner who owns the business to actually becoming the CEO of the business because they're very different jobs, those two things.
• 1:11
  SPEAKER_00: And I want to talk to you about what that transition actually looks like.
• 1:16
  SPEAKER_00: Because I think a lot of PT owners know they need to work on the business instead of in the business.
• 1:22
  SPEAKER_00: You've probably heard that before, but few people really explain what that means practically.
• 1:27
  SPEAKER_00: So let me break it down just a little bit here.
• 1:30
  SPEAKER_00: When you first open a practice, it makes complete sense that you're doing everything.
• 1:34
  SPEAKER_00: You shouldn't have a lot of people doing different jobs because the business can't hold that much payroll and it can't hold that many people right now.
• 1:41
  SPEAKER_00: You're treating patients at this point, you're talking to referral sources, you're answering questions, you might even be answering the phone and you're solving problems as they come up.
• 1:49
  SPEAKER_00: And then you're actually trying to fit the actual business work into whatever time is left over, if there is any time left over.
• 1:55
  SPEAKER_00: And actually, for a while, you can do that.
• 1:58
  SPEAKER_00: I've done it for a while and it was what was necessary.
• 2:01
  SPEAKER_00: The problem is that if the business continues to grow, eventually, you've created something that depends so much on you in so many different places that you can't really leave any of them.
• 2:10
  SPEAKER_00: I've said before that a lot of practice owners don't actually own a business yet.
• 2:14
  SPEAKER_00: They feel like they own a business because they have, you know, the EIN and they have the name of the business and it's mine, mine, mine, but really they don't own a business.
• 2:21
  SPEAKER_00: What they own is a very demanding job with their name on every organization pillar.
• 2:26
  SPEAKER_00: And I actually don't say that to be insulting at all.
• 2:29
  SPEAKER_00: I say it because there's an important distinction there.
• 2:32
  SPEAKER_00: If the business needs you treating 40 hours plus a week and it needs you to make the important decisions and it needs you to solve the problems in every org pillar, and it needs you to maintain the important relationships, et cetera, et cetera, then you may own the equity, but operationally, the business is still built around your presence and attention.
• 2:49
  SPEAKER_00: And actually, I dare say the business owns you.
• 2:52
  SPEAKER_00: And that's what has to change.
• 2:54
  SPEAKER_00: If you want to build something bigger, and by bigger, I don't mean larger in size.
• 2:58
  SPEAKER_00: I mean bigger for life, for your impact.
• 3:00
  SPEAKER_00: And one of the ways I think about it is called PT, the CEO transition.
• 3:05
  SPEAKER_00: There's an analogy I use with the Sea of Galilee and the Dead Sea because they're both receiving water and the same water source at that, but one has an outlet and the other doesn't.
• 3:14
  SPEAKER_00: You see, the Dead Sea doesn't have an outlet and it doesn't have any real life in it or around it.
• 3:19
  SPEAKER_00: Whereas the Sea of Galilee has an outlet.
• 3:21
  SPEAKER_00: Even though both have the same incoming water, they are vastly different in how they give and in how they flourish.
• 3:28
  SPEAKER_00: The Sea of Galilee has so much fresh life as a result of having both an inlet, which is receiving, and an outlet, which is giving.
• 3:35
  SPEAKER_00: I think owners need to start looking at their time the same way.
• 3:38
  SPEAKER_00: But do they receive four-time requirements and what do they give?
• 3:42
  SPEAKER_00: As a clinician, a lot of your work is necessarily consumed in the moment.
• 3:45
  SPEAKER_00: A patient comes in, you give them your time and your expertise, and hopefully they get a great result.
• 3:50
  SPEAKER_00: And then the next patient comes in and you're just right back at it.
• 3:53
  SPEAKER_00: That is wonderful.
• 3:54
  SPEAKER_00: But from the standpoint of building a company, you have to start creating things that continue producing after the time that you spent creating them is over.
• 4:02
  SPEAKER_00: And that was something that weighed heavy on me for so many years.
• 4:05
  SPEAKER_00: I remember when I was coming more off the treatment floor.
• 4:08
  SPEAKER_00: The question that was asked by the people that led the company with me was what will the patients do if they don't receive the high quality of care that you're giving?
• 4:16
  SPEAKER_00: At the time, we had three total clinics, and I just remember asking the question, what will the other two clinics do that I can't be at?
• 4:23
  SPEAKER_00: That's when it was a clear decision for me to be able to perpetuate the quality that I would give to my patients throughout the entire organization and not just in the clinic that I could spend my time in.
• 4:33
  SPEAKER_00: So maybe that's developing your team so they can make decisions they used to bring to you.
• 4:38
  SPEAKER_00: Maybe it's putting a standard in place so everybody understands what good care actually looks like.
• 4:43
  SPEAKER_00: And maybe it's creating a system that solves something you've personally been solving over and over and over again.
• 4:48
  SPEAKER_00: The specific thing is going to depend on your company, but the question I would ask, I would make it pretty simple.
• 4:54
  SPEAKER_00: You see, when you look at what you did last week, how much of that work is still producing something this week without requiring you to do it again?
• 5:02
  SPEAKER_00: Because recurring crises are the evidence of slovenliness and laziness.
• 5:07
  SPEAKER_00: It's a mouthful, but it's true.
• 5:09
  SPEAKER_00: Because that's a very different way of thinking about your time.
• 5:12
  SPEAKER_00: And once you start thinking about it that way, you realize that becoming the CEO isn't really about finding some magical extra 10 hours that doesn't even exist in your week.
• 5:21
  SPEAKER_00: It's not about someday that time's going to appear.
• 5:24
  SPEAKER_00: It never works that way, actually.
• 5:25
  SPEAKER_00: But there is a way to magically create those 10 hours, so to speak, because it's much more about deciding what deserves the hours you already have.
• 5:33
  SPEAKER_00: Hear that.
• 5:34
  SPEAKER_00: Time management actually is not time management.
• 5:37
  SPEAKER_00: After all, it's really priority management.
• 5:39
  SPEAKER_00: And if done well, it can change the way you have to show up with your time in other areas.
• 5:44
  SPEAKER_00: The greatest part of my career progression has been learning how to get time back.
• 5:48
  SPEAKER_00: And really, the way you get time back is not managing it, it's managing priorities.
• 5:52
  SPEAKER_00: Many owners I've worked with are not just sitting around wasting half their week.
• 5:56
  SPEAKER_00: They're hardworking people.
• 5:57
  SPEAKER_00: And they're usually doing legitimate things that somebody does need to do, and they're doing a lot of it.
• 6:03
  SPEAKER_00: The question is actually whether they need to be the person doing them.
• 6:07
  SPEAKER_00: Let that sink in for just a minute.
• 6:08
  SPEAKER_00: There's an old Stephen Covey illustration with the rocks and the gravel and the sand and trying to fit all of it into one container, like a jar, let's say.
• 6:19
  SPEAKER_00: The point of the illustration is that if you don't put the big rocks in first, these would be big priorities in your life, you'll fill the container with smaller things and there won't be room for what matters.
• 6:30
  SPEAKER_00: But if you put the big rocks in, which are the right priorities in first, then all the rest of the medium and small rocks and the sand can actually fit in together.
• 6:39
  SPEAKER_00: So you don't actually have to miss out on the things that you care about.
• 6:41
  SPEAKER_00: But if you don't put the priority right, you will miss out.
• 6:44
  SPEAKER_00: I think there's another part of the lesson that's especially important when you're running a company, which is that you have to become comfortable with the fact that not everything is going to fit totally inside of a jar.
• 6:55
  SPEAKER_00: There will be some things that you have to let go of.
• 6:57
  SPEAKER_00: And that's really hard for high-performing people.
• 6:59
  SPEAKER_00: You've got 10 things that are all worthwhile or however many you got, and they're all useful and all capable of helping the business.
• 7:06
  SPEAKER_00: And maybe you have the capacity to do three or four of them really well.
• 7:10
  SPEAKER_00: The CEO's job is deciding which are the top one, two, three priorities.
• 7:15
  SPEAKER_00: Because if you keep treating every good thing or every idea as something that deserves your attention right now, you will stay incredibly busy and still wonder why the business and the company isn't moving in the direction of your goals.
• 7:28
  SPEAKER_00: Do you want to be busy or do you want to be successful with your goals?
• 7:31
  SPEAKER_00: You can be busy with good things or you can be busy with great things that actually move you towards your goals.
• 7:36
  SPEAKER_00: And if you're a PT owner who's trying to build a company that can grow without requiring more and more of you personally, hit subscribe.
• 7:43
  SPEAKER_00: That's really what I want to do is help you with this channel and helping you create a business that serves you.
• 7:48
  SPEAKER_00: Now, there is another transition that happens here that I think is particularly difficult for clinicians because our education actually trains us in the opposite direction as where we need to go with this.
• 7:59
  SPEAKER_00: You see, as a doctor of physical therapy, you're trained to deal with complexity.
• 8:03
  SPEAKER_00: A patient walks in and they don't fit the textbook presentation, and there are many things going on at once, and they've already tried multiple different treatments and different places.
• 8:12
  SPEAKER_00: And part of what makes you good is your ability to hold all of that information and figure out how to decode all that and figure out what matters.
• 8:19
  SPEAKER_00: That's a valuable skill clinically.
• 8:22
  SPEAKER_00: But when you're leading a company, you have to be careful about assuming that a complicated problem actually requires a complicated solution.
• 8:29
  SPEAKER_00: I've watched countless owners build a tremendous amount of complexity into their businesses because complexity can feel thorough and it can feel meaningful, it can feel sophisticated, it can feel like we're taking the problem seriously, the more complicated the solution.
• 8:44
  SPEAKER_00: Most of the time, the business doesn't need any of that.
• 8:47
  SPEAKER_00: It needs simplicity on the other side of complexity.
• 8:50
  SPEAKER_00: Sometimes we need to understand the problem well enough that we can make the solution simpler.
• 8:54
  SPEAKER_00: And most of the time, the simpler the solution, the better the execution, the better the solution.
• 8:59
  SPEAKER_00: And I think that's an important evolution from practitioner to CEO because your value is no longer just in how much you know or how much you can personally handle.
• 9:08
  SPEAKER_00: Your value is in increasingly and progressively finding your ability to create clarity for everyone else.
• 9:14
  SPEAKER_00: And that brings me to leadership because there's another thing that changes when people start depending on you.
• 9:20
  SPEAKER_00: I like to use what I call the engagement scale.
• 9:22
  SPEAKER_00: And it numerically runs from a zero down here to a 10 up here.
• 9:27
  SPEAKER_00: Just mentally, it helps me to think through it.
• 9:29
  SPEAKER_00: And one of the things I tell leaders is that your level of engagement is going to affect the level of engagement you can reasonably expect from the people you're leading.
• 9:37
  SPEAKER_00: Your engagement will be greater than your team's engagement.
• 9:40
  SPEAKER_00: If you can accept that, you can really elevate yourself to really effectively help other people be more engaged.
• 9:47
  SPEAKER_00: If you're asking your clinic directors to operate at a 10, for example, while you're showing up at a seven, hoping that they pick up the slack, they will fill that.
• 10:05
  SPEAKER_00: Because the assumption is that leadership is going to be about making decisions, setting goals, holding people accountable.
• 10:11
  SPEAKER_00: It is, but it's also about leading yourself well enough that other people can rely on you.
• 10:16
  SPEAKER_00: I think that's worth repeating.
• 10:17
  SPEAKER_00: It's about leading yourself so well that other people can actually rely and believe that you are a leader worth following.
• 10:24
  SPEAKER_00: We're all going to have stressful weeks, especially as a practice owner.
• 10:27
  SPEAKER_00: You're going to have them.
• 10:28
  SPEAKER_00: And numbers sometimes pop up that you don't like.
• 10:31
  SPEAKER_00: Personal things can happen outside of your work because you're a human being and that's life.
• 10:35
  SPEAKER_00: But once you're leading an organization, the way you carry those things inside of the organization affects more than just you.
• 10:42
  SPEAKER_00: And so it's a call to greater ways of being.
• 10:44
  SPEAKER_00: It doesn't mean you become fake or pretend you're having a wonderful day when you're not.
• 10:49
  SPEAKER_00: You can be real and authentic, but it means you develop the ability to recognize what state you're in before you start making decisions from that state, that state of being that you're in.
• 10:59
  SPEAKER_00: And that leads into one of the most useful frameworks I have for myself, which is state story strategy in that order.
• 11:07
  SPEAKER_00: State story strategy.
• 11:08
  SPEAKER_00: State is what's happening with me.
• 11:10
  SPEAKER_00: Maybe I didn't sleep well.
• 11:11
  SPEAKER_00: Maybe I'm stressed about the numbers that are showing up.
• 11:14
  SPEAKER_00: Maybe something happened at home.
• 11:15
  SPEAKER_00: Maybe somebody decided not to show up to work.
• 11:18
  SPEAKER_00: Maybe I'm frustrated with somebody on the team for not showing up to work.
• 11:20
  SPEAKER_00: Maybe I'm thrilled about all of my progress.
• 11:23
  SPEAKER_00: There's lots of different states.
• 11:25
  SPEAKER_00: Then there's the story I'm telling myself about whatever is happening.
• 11:28
  SPEAKER_00: The story is a powerful thing.
• 11:30
  SPEAKER_00: Only after I've looked at those two things, state and story, do I want to get into strategy.
• 11:35
  SPEAKER_00: Because strategy is where I'm actually deciding what to do.
• 11:38
  SPEAKER_00: But it comes third.
• 11:39
  SPEAKER_00: The reason the order matters is that when you're under pressure, it's very easy to jump straight to strategy because making a decision gives you the feeling that you're doing something.
• 11:50
  SPEAKER_00: But if I'm making that decision from a poor state, low state, low energy, and I built a story around the situation that isn't completely accurate, I can make a very confident decision that creates a problem I now have to live with for months.
• 12:02
  SPEAKER_00: And I've done that.
• 12:03
  SPEAKER_00: I've made so many decisions too quickly because I wanted the issue resolved.
• 12:07
  SPEAKER_00: And in the moment I could make a perfectly logical case for why I was doing it.
• 12:11
  SPEAKER_00: And that's why I try to slow that sequence down now.
• 12:15
  SPEAKER_00: What's my state?
• 12:16
  SPEAKER_00: What story am I telling myself?
• 12:17
  SPEAKER_00: And now, knowing those two things, what's now my strategy?
• 12:21
  SPEAKER_00: And if you zoom out, all these things are really getting at the same transition that we've been talking about this whole time.
• 12:28
  SPEAKER_00: When you're a clinician, so much of your value comes from what you can personally do.
• 12:33
  SPEAKER_00: It changes though when you start to transition from clinician to CEO.
• 12:36
  SPEAKER_00: When you become the CEO, more and more of your value actually comes from what the organization can do because of what you've built, who you've developed in the organization, what you're prioritizing, and how well you've learned to lead yourself.
• 12:51
  SPEAKER_00: How well can we actually learn to lead ourselves?
• 12:54
  SPEAKER_00: It's such a powerful part of this whole equation.
• 12:56
  SPEAKER_00: It's a very different job and it can be uncomfortable because you're stepping away from the thing you're already very good at and spending more time doing things you're still learning how to do.
• 13:06
  SPEAKER_00: So when you step out of what you're familiar with into the uncomfortable and the less familiar, it can be something you hesitate on, but you don't need to.
• 13:13
  SPEAKER_00: That's the work you want to lean into and dig into if you want to really build a business that serves you and not the other way around.
• 13:19
  SPEAKER_00: If you actually want to build that company that doesn't require your presence at all times, eventually you have to stop measuring a productive week only by how much you personally got done.
• 13:28
  SPEAKER_00: And you need to start looking at how much stronger the business became because of where you put your attention.
• 13:32
  SPEAKER_00: You see, I also look at this framework of be the guide, not the hero.
• 13:36
  SPEAKER_00: And that's another excellent way to transition.
• 13:39
  SPEAKER_00: I want to add one thing here because I don't believe everybody needs to build a 10 million plus dollar practice.
• 13:45
  SPEAKER_00: I do believe that if you're not growing, you're fading.
• 13:48
  SPEAKER_00: And I also believe that the way that we serve people and how well we serve them is how well we get compensated.
• 13:55
  SPEAKER_00: The more that we can actually build our practice to serve many people and serve them well, the more we get compensated.
• 14:00
  SPEAKER_00: And so it does matter.
• 14:01
  SPEAKER_00: That's not the point to just have a more prolific practice with more revenue.
• 14:06
  SPEAKER_00: If you want one location and you design that business intentionally to give you the life you want, I think that's fantastic.
• 14:11
  SPEAKER_00: What I don't want is for somebody to tell me they want five locations or 10 or 20, and then continue building a company where everything important still depends on them.
• 14:20
  SPEAKER_00: Those two things do not go together.
• 14:23
  SPEAKER_00: You see, the business has to be built to serve the life you're trying to create, not consume the life you're trying to create.
• 14:29
  SPEAKER_00: And part of doing that is becoming the kind of leader who can build something that works beyond your own individual effort.
• 14:36
  SPEAKER_00: And there's beauty in that.
• 14:37
  SPEAKER_00: And there's great value in that.
• 14:39
  SPEAKER_00: So here's what I'd have you do.
• 14:41
  SPEAKER_00: Open up your calendar from last week and take a very specific look at where your time actually went.
• 14:46
  SPEAKER_00: Because your calendar will usually tell you the truth faster than you're going to tell yourself the truth.
• 14:51
  SPEAKER_00: Look at it.
• 14:51
  SPEAKER_00: How much of your week was spent doing the work of the practitioner?
• 14:54
  SPEAKER_00: Now, if it's not on your physical calendar, take a real deep look at where you spent your time.
• 14:58
  SPEAKER_00: Really, really take a look at it.
• 14:59
  SPEAKER_00: Down even to the minute.
• 15:01
  SPEAKER_00: How much was spent solving things other people could eventually learn to solve?
• 15:05
  SPEAKER_00: And how much time did you spend producing something that makes the company stronger without requiring more of you the next week?
• 15:10
  SPEAKER_00: It does require putting ego aside, but it's so worth it.
• 15:13
  SPEAKER_00: You don't have to change your entire role Monday morning.
• 15:16
  SPEAKER_00: And depending on where your practice is today, you probably shouldn't.
• 15:19
  SPEAKER_00: It's good to have a transition.
• 15:20
  SPEAKER_00: But you do need to start making that transition intentionally because you're not going to accidentally wake up one day as the CEO of a company that is stable, that can actually operate without you.
• 15:30
  SPEAKER_00: And see, one of my litmus tests is can I walk away for a period of months and still have operate as good or better?
• 15:37
  SPEAKER_00: That's one of the things that I look for.
• 15:38
  SPEAKER_00: And if you're trying to figure out where your company needs to develop next, watch this video on why PT practices stop growing because they break down the breakpoints companies hit as they get larger and how to recognize the part of the business that isn't ready to carry the next stage of growth.
• 15:52
  SPEAKER_00: I'll see you there.