The Challenges Of PT – Recruiting, Facing Changes, And Emerging EMRs With Will Humphreys Of Rockstar Recruiter

Recruiting for PTs, general tendencies of PT owners, and emerging EMRs to consider – we talk about it all in this episode of PT Owners Club with special guest, Will Humphreys. Will has his pulse on the PT world with his work in recruiting, Rockstar Recruiter, clinic sales, Multiplexit, billing and collections, and In the Black. He talks about some of his recent experiences attending recent events lending and shares his general takeaways that could help every PT owner.

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I’m bringing back my good buddy, my best of all friends, Will Humphreys . Thanks for joining me.

Best friend status. Thanks for having me back. It’s the best show in the world. I love it.

That means a lot. I know you’ve been on a lot of them in the past.

It’s weird though. We have talked about this before. I don’t think people come up to you the way they come up to me. They’re like, “I know you. You’re on that amazing show,” whether it’s CSM. Your name comes up all the time. In my world too when I’m coaching PTs, we will refer you, not knowing that I know you. They’re like, “I was listening to this thing on this show.” I always go, “Which one?” They will mention it’s yours. I always get to say, “That’s my buddy. I know who exactly that is.” They’re like, “No way.” It’s this cool thing.

You’re stroking my ego. Thank you.

It’s all true. Thanks for having me.

You’ve been doing a lot so I thought it would be a good time to catch up and see what’s happening in your world. You’ve got big things going down, not just in the past but in the future.

There’s nothing bigger than the Taylor Swift concert I’m going to.

Did you my lead-in on that? Is that pretty cheesy?

I did. People who are reading this don’t know that we had a 30-minute conversation about Taylor Swift right before this conversation. Neither one of us are a particular fan of hers.

Thank you for saying that.

That’s what we agreed to say but we’re very big and dirty Taylor Swift fans. My wife is excited about it. The thing that we were talking about is that in that Taylor Swift concert, people are dressing up in inspiration of one of her albums. The clothing going into this thing is massive. People are dressing up in all these things. I’m excited to be there because this will be one of those things. Taylor Swift will be one of the names that are going to be around forever. I’m doing that. I’ll be at the Glendale State Farm Stadium on the opening night for her concert. It will be fun.

That’s exciting. That sounds fun. It will be great. It’s one of those things that you sacrifice for your spouse.

I don’t mind. It will be fun. We got VIP passes. We’re going to hang out with her backstage.

Are you serious?

I’m kidding.

I would be impressed by that.

I would nerd out. If she hears this, I love you. You’re the greatest thing ever.

You have been doing a lot in the industry with your many entities going on in the past. Last time, we talked about our experience at PPS . We were pissed off at some owners that still take low-paying insurance. Since then, I’ve had an episode with Trace Kennemore out in Tennessee, dropping UnitedHealthcare and his experience there. A couple of episodes before that, I talked to Steve Edwards in Vegas about his dropping of low-paying insurance. All these things are so positive. I’m excited because I’m talking to more of my clients. People are asking me about dropping the insurance as well. There’s more energy behind that. You spoke about it in your town hall meetings as well.

Those are still happening every month. It has been super cool to see how PT owners are starting to take a stand for the industry when they take a stand for their profits by considering the possibility of a life without these insurance companies taking advantage of us. I’m particularly in the town halls. I don’t promote any of the companies because all of my companies promote PT owners and are facing them to help them but this is the one area where I’m like, “I don’t want to confuse those things.”

We talk specifically about how we can unite the industry around this. We had Kristin Fox from South Dakota, the upcoming APTA President. We’re going to have Seth Coulter who was a founding member of a company called Rehab Net. All of these entities are built for private practice owners to fight insurance companies, negotiate better reimbursement and help them take a stand against all this suppression.

The show moving forward is a Zoom meeting but I’ll put it on my YouTube channel. What we do is talk about how we’re going to make this a national effort. It’s starting to take action and get some traction. It has been cool how that happens. Sometimes we will have 40-plus company owners on it and then we will have 5, 30 and then 2 but a lot of people listen to it afterward. It has been a lot of fun.

What else have you been doing? You went to CSM . You’ve had a leadership conference for MultiplExit . What else have you been doing?

CSM was special this time around. I had this vision starting a few years ago when I saw these big PT companies. 60% to 70% of their lead generation for new hires happens at CSM. I learned it from ATI specifically. If you are reading this, thank you so much. I appreciate your help. They do recruiting so well at ATI. It was cool because their story is truly authentic, “Our stock is in the trash. Here’s why. Here’s how we’re fixing it. Our company is turning it around.”

They’re taking that Domino’s Pizza approach to the negative feedback and then turning it into a positive reason to grow but either way, they won’t have this massive booth. They talk to students all day long. CSM is Combined Section Meetings. It’s the largest national conference we have in the PT world. There were 13,000 to 15,000 people. There’s a rough estimate. Fifty percent of that is students or new grads.

What we did in 2023 for Rockstar Recruiter is that I offered it to any of my partners to come to CSM. I paid the $8,000 to rent the booth and sponsor the night-before event that was geared toward students. In exchange for a nominal fee, they flew down. We created one booth where we helped each other recruit. We called it Rockstar PT. What we said was, “We are a rockstar network of the best private practices in the country looking to serve the new generation and helping them build the future in PT they deserve. We would help you with learning how to find the right employer, how to do mock interviews and all these things.”

We had over 150 students sign up for mock interviews for 8 of our companies. There are only eight companies that came. We did a masterclass that we had over 350 students sign up for. It was awesome. I released the video and made it public. That video has well over 1,000 views. It’s teaching students how to interview their future employers.

In there is a PDF of the Rockstar companies that work with me. That’s why I don’t take on anybody. I’m looking for companies that I believe in and that are going to create an experience for PTs where they will be grateful that I recommended them. It has been amazing. We have had a few hires out of it already. We were piloting it for the first time. It was so cool. In 2024, we’re doing this thing on steroids. It’s one of the ever-growing benefits of the Rockstar Recruiter program. It was cool because it wasn’t like we were exposing them to recruiting. I was teaching them how to run the event.

People go to student fairs and go, “I attended the student fair. I didn’t hire anyone from it.” You’re doing it wrong. There’s a way to do it that’s standardized and processed to where you go and produce an experience that creates a call to action that gets them on the hook to learn more about you and your company. You start guiding them down that trail until they end up in your practice. It was fun. That was a dream of mine to try. It’s expensive this time around. In 2024, I’m going to make sure I don’t lose money on it. It was useful for my clients to make sure they learn this skill and get palpable leads right then for the next year.

It’s cool that you were able to bring your vision to fruition. These PT owners from across the country didn’t have to shell out $8,000 and put their one little table out. You got a little army there of owners who are promoting not only their clinics but everyone else’s. You are coming at it as a team, which was a cool experience. I’m glad you were able to see that come to pass.

It was powerful that it worked. The thing I wasn’t sure about is how these different brands show up together. When I was working at Empower and I was over those 26 locations recruiting, it wasn’t that hard to recruit because I already had these lead gen activities in place. It’s almost like physical therapists see how big a company is and go, “If it’s that big, it must be good.”

When I was helping these Rockstar Recruiter clients talk about each other, I would say, “No one can tell John how wonderful John is better than anyone else.” I was there. The other thing that I did for my clients and they started doing for each other was that someone would be talking to somebody from Alaska and I would say, “Do you want to live in California? Let me introduce you to this other company.” I would walk them over and make sure that they made the Alaska company still have their contact information and did that. I would walk them over to the California people and go, “If I was you, this is where I would work. I get nothing out of this financially by saying that. Here’s why I would work here.”

I would tell them why that company would be hard to work for. I did that on purpose. I would be like, “Here’s where they’re struggling.” The biggest thing I learned in recruiting is the more people feel like they can understand the full picture of it, including the weaknesses of that company, the more likely they are to imagine working there, which is how they end up deciding to take the offer. They all know no one is perfect. We can highlight authentically what that imperfection looks like without even trying to spin it.

In recruiting, the more people feel like they understand a company, the more they imagine working there, which is how they end up taking the offer.
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I tell them, “This is where they’re at. They’re young. They don’t have their processes in place. You will love your patient care but you may not always know your feedback or how you’re doing. You might want to be aware that you will have to be a leader to help them understand that you need more feedback and maybe that’s an opportunity for you to become a leader and help organize that.” It was a cool experience because they started doing that for each other. Hundreds of student leads for eight companies occurred. We’re still following up on all these leads almost a month later. It has been fun.

There are two things about that. I saw this on a YouTube video from our friend, Alex Hormozi . He talked about how he did sales pitches and switched things. People tend to bring their sales pitch and say, “This is the amazing result you’re going to get but you’re going to have to do this amazing amount of hard work and grind.” He switches that to putting in the hard work and grinding in front of the but and leaving amazing results after the but. You did that. That’s what I’m wanting to highlight.

Joining this program is going to be super hard. I don’t know if it’s the right fit for you. You’re going to have to put in some extra hours. You might not have the time. It’s going to be a real grind but if you do it, you’re going to see amazing results. In your case, you’re going to get these amazing hires or find a place that has amazing values and culture that you’re going to have a chance to build with. He puts the hard part at the front and then the but after. Your mind stops remembering what happens before the but and only remembers what you say after the but.

I never heard that. That’s brilliant. I did that by accident. When I start talking to people, I’m going to reverse that because when people want to join Rockstar Recruiter, I don’t like bringing people on and taking money. I want them to have the results that other people can. When you’re coaching, it requires effort on the other part. It’s like being a physical therapist. Someone can show up to their visits but they do none of their home programs, don’t follow their protocols and don’t push themselves in the right way at the treatments. They blame you for not getting better. When you get someone who shows up and they’re committed, you can almost guarantee results. Honestly, you can guarantee results. It’s the same.

I’m going to start doing that when people join because I sometimes overemphasize the work and it’s not a lot of work. Rockstar Recruiter is an hour a week but you have to do an hour a week. If people aren’t able to commit to that, then it’s not worth their time but if they can commit to that, those results are amazing. I loved seeing dozens of companies go through the program and hire PTs. Getting that testimonial thing is one of the coolest things ever. Seeing how people have been able to transform, not just hire people but build a dream team and start to experience freedom is a wonderful thing.

The other thing I was going to ask is this. Are you seeing more owners focusing on graduate students and PT programs? I’m sure you are because what you’re promoting and treating training them to do is to visit the PT schools but I wonder if PT owners are taking hold of that and trying to be more proactive about being engaged with the 1st, 2nd and 3rd-year students in their PT programs locally.

They are getting better at it. In my program, I’ve got people who are running virtual career fairs in their region with each other. We’ve got a group of people in the Northwest with the training that we teach. It is student-focused. To answer your question, where PTs need to focus their efforts on hiring has to deal with their unique needs. That’s why we want to create the ideal hire before we recruit. In most cases, the student population is a great place to start but the end product or the real secret sauce to what we do at Rockstar is we teach owners with minimal effort how to create a brand and some public awareness so that they are thought leaders toward the things that their avatars care about.

In our world at Rise Rehab , we wanted entrepreneurs. I would speak at a student event. Before I started my discussion on how to build your future in PT, I would go, “Who here wants to open their practice one day?” Back then, four hands would go up. I would go, “I want the four of you to meet me right afterward. I’ve got something cool for you. We’re going to grab lunch. We’re going to have a whole journey together. I can’t wait to share it with you.”

I would go into my speech because I knew how I was trying to target them as they started having success in working for Rise Rehab and telling their friends. When you have 26 locations, it wasn’t hard to hire people who were willing to drive into remote rural areas when they knew what they were getting was more than a job but an experience to build their dream. We have to understand whom we want to hire and their dreams and then build our offering to meet the dream.

When are we the most passionate? It’s in the school phase of our journey or when we’re students. That’s why it’s so great to target universities and do all these things that we teach. What’s great is that every PT could talk to their university. They will have increased success but there’s a way to do it to where it becomes a plug-and-play. You run your program every year and start building not just enough hires but enough people on the bench to want to join. It’s fun to see that. Typically, universities are where we focus. People across the board are figuring that out.

Your Rockstar Recruiting program isn’t just for graduate students because that is more of a long-term play. A lot of your stuff is focused on getting that immediate hire, not waiting for the student but for someone to come in here within the next month or two. I wanted to highlight that so that people understand that Rockstar Recruiter is not about getting a graduate student.

That’s a product of one thing of it. Thank you.

You also had your conference with MultiplExit.

I did. I’ve had a leadership conference through the Healthcare Business Academy , the HBA. We have had buy invites. As you know, I have three companies that I’m working in. In The Black and Rockstar Recruiter are usually the primary ones that I spend most of my time growing and talking about. The HBA started its first leadership conference in August 2022. We had our second one in January 2023. It was unreal. For me, it was so special because these are people who are working in the HBA, In The Black or the Rockstar Recruiter world who are coming in. We’re helping them grow and scale.

There’s MX where we’re helping companies prepare or coach companies on getting ready for exiting through MX or MultiplExit. These two-day conferences are fantastic. It’s a summary of everything that you and I have ever done and every conference I’ve ever been to for the Entrepreneurs’ Organization. I’m not bragging because it wasn’t me. It was a whole team of people that did this. When people were leaving in tears saying, “This was life-changing,” I thought, “This is what I was born to do.”

The conferences for me are the coolest things I get to do. We do them every quarter. Our next one is at the end of April 2023. We haven’t opened up to the general public yet. We’re only keeping those for clients of mine currently but I do see a day in 2024 when it will become a big thing because we don’t have enough conferences. Greg Todd does a cool thing once every May. We need more of those things. PT leaders need more support, groups, affiliation and education. These conferences are nitrous boosts of accelerant of our process and growth. It’s all fun and difficult. It’s always challenging but way fun.

Physical therapy leaders need more support, groups, affiliation, and education. These serve as nitrous boosts of accelerant for their process and growth.
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There’s always a huge boost when it comes to networking. A lot of times, the presentations can be valuable but when we go to these conferences, our biggest takeaways were our conversations with other PT owners in between the breaks or at dinner. It’s so valuable. It’s one of the steps that I promote. I haven’t promoted a lot but if you check out my previous episode, it’s to reach out, step out and network. I don’t talk about the networking part of that enough.

We talk about reaching out and getting consulting and coaching. We talk about stepping out and getting out of patient care but networking was the third part. It’s a strong spoke on that wheel of getting independence, growth and expansion in your clinic. That’s where the conferences are super valuable. There aren’t a lot of them. PT owners don’t make as much of an effort as a whole to go to them and network, honestly. That’s a comment but the question I have is this. It’s weird that you say it was an amazing experience for you because I know it wasn’t during the conference.

At that conference, one of the things that I do well and it sucks for me is that I create a safe place for people to vocalize their experiences and journey. In this last conference that I had, we started dealing with concerns and all these things that people have in their journey. With the way the direction of that discussion was going, it could have very easily turned into a complaining session and a major frustration vent in a way that wasn’t productive and not the educational inspiration that it was meant to be.

For a number of hours, I was pivoting on stage during my presentation because my presentations are incredibly interactive. I don’t talk to people. I leverage things and we talk about it. There was a challenge to the things I was teaching and a lot of frustration. People were being burned out. In the end, it worked. I was able to be in a position where one person told me, “I’ve never seen someone on stage take so much negativity and shift it.” I don’t enjoy that part of it.

My conferences are very niche and unique. I can’t get into more detail which may be a little confusing for the audiences but I only like to do things with people unless we get incredibly real. I don’t love the conferences that we have currently because you attend a class and then skip something. If someone shows up at my conference, they’re attending 100% of everything or I don’t want them to come. The content is intentionally created to bring up any fear, concern or issue they have. They lay it out there and then we deal with it, which is why we get life-changing experiences out of it. That part is why I tolerate these other steps. It can be a lot on my end but it’s all right. This is the world I live in.

Can I make a generalization that the issues that you had to face during that conference tended to be around this fact? Maybe this is for entrepreneurs as a whole no matter what the industry but for physical therapy entrepreneurs, in general, there is a lot of fear around change. Would you say that was the basis for the issues that came up during the conference?

We’re dancing around parts of it. I appreciate that. We can’t get into the great minutiae because of confidentiality but I will say this. People who come to those conferences are committing to a specific change. There’s a great deal of accountability to that change. When people have to change, that’s when all their fear comes out. That’s what I was dealing with. What’s funny though is having been on the other side of it, I listened to people’s major concerns. The whole time I’m like, “You’re so afraid of making a change that is going to open up all this opportunity.”

Here’s what’s at stake. If people don’t make that change, they’re going to stay the same. They admittedly say they’re miserable and can’t stand it and they want out. Someone who has been through it with the help of a lot of people is telling you this is how you get out. Once they start getting out, they go, “I don’t want to leave this comfort zone of hell that I’ve been in because what if it’s worse?” They freak out and you’re like, “I get it.” I’m not judging the individuals. It’s the nature of fear.

It becomes an incredible opportunity. The thing that I did that was smart is I didn’t try to solve their fears. I took them through a process called Fear Setting with Tim Ferriss. People started addressing their concerns and fears over the changes that we were making. It was beautiful. These powerful leaders stood up to control their lives and started running with the football. It was so inspiring by the end. That’s the thing we forget as leaders. We think life is supposed to be a happy patient visit.

How do our patients get better? How do they experience growth and overcome adversity? It’s through the pain of learning how to contract a weak muscle, a passive range, a frozen shoulder or overcoming the fear of not having balance when we walk. Everything that we want is on the other side of discomfort. When we’re uncomfortable and we have an opportunity to make a change, what do you have to lose? Most people are so burned out. They don’t know. They’re like, “I’m burned out. I don’t want to make that worse.” That could be the one thing but isn’t that also the definition of insanity?

“I am miserable but I’m not going to do anything different. I’m going to keep seeing more patients. More new patients will solve it. I can get more referrals. I’ll have a less insane week. For that brief moment, I can come out for air and maybe take a day off.” How can we make a big change to where you’re happy every day, you’re not stressed and you can float through your day with ease? That takes a lot of pain. The pain of not changing has to exceed the pain of change for us to make a change. That’s true. Fear is the only reason we don’t know that it’s not nearly as painful as we think.

I did the same thing in a small stint with a PT owner where we looked at his financials. He’s considering dropping UnitedHealthcare, specifically. I said, “Let’s take your annual numbers. We will drop those total visit numbers by 15% because that was the number of visits that were UnitedHealthcare patients. We will drop your gross revenues by 10% because that was what 15% of UnitedHealthcare patients represented in your gross revenues. We will see what the average reimbursement per visit is minus those two things.” It went up to $6 to $8 per visit.

He’s like, “What about all those patients, all those visits that aren’t there anymore and the lost revenue?” I said, “Do you currently have patients that have difficulty rescheduling or are not able to get in at the frequency that they want to get in per week?” He’s like, “Yeah.” I’m like, “You have room to put those people in. Do you have a waiting list of about 1 or 2 weeks to get new patients in? They can come in and see you sooner.” Patients can get in sooner and get better faster because they can come in at the frequency that they’re supposed to achieve their goals.

You will have an increased reimbursement rate. It will make up for the “lost” patient visits of UnitedHealthcare. “Would your front desk be happy if they didn’t have to deal with the authorization bullcrap that UnitedHealthcare puts all their patients through?” He’s like, “Yeah.” Even after that conversation, there’s still that hesitancy. It’s a natural thing. We can talk to our kids and present to them, “You do have other options here besides staying on this one path. What if you made a change?” They’re like, “It might be worse than what I’m currently in.” Possibly but you can still make a change from that. You don’t have to stay.

That’s a good point. It can change off of that if it is worse. You will probably learn something that in the end makes it better. I’m guessing.

If you drop UnitedHealthcare, maybe your visits do go down. What if your revenues don’t come up? Let’s market a little bit more. You’re going to get more new patients that come in at an increased reimbursement rate per visit or maybe you thin down your employee total and make them more efficient and productive. Who knows? There are a lot of options. The best interest of the patients ends up being in the best interest of the business, which helps the owners. I can see that happening in the small experience that I had in talking about UnitedHealthcare with an owner.

When you were talking, it was clear to me. The bigger limitation in our industry isn’t fear that we share. It’s the exhaustion. I honestly believe PT owners are incredibly courageous. The reason they’re so captivated by their fear is that they’re too tired to do anything else. That’s the real problem. I’m sure as you’re driving to or from work, you’ve got a billion things on your plate still. There’s this feeling of fatigue. What keeps us in it is the satisfaction of what we do.

The biggest limitation in the PT industry is the exhaustion. PT owners are incredibly courageous, but they are captivated by their fear that they are too tired to do anything else.
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Most industries wouldn’t tolerate so much that we do, including our burnout but there’s so much amazing purpose in treating patients and building teams and stuff so that when we come home at the end of the day and we’ve only got fumes left for our kids, there is a sense of accomplishment. I don’t think that would exist if we were making donuts.

We stay in that cycle. It’s almost like the sense of accomplishment coupled with extreme exhaustion makes it to where when someone hears you talk about dropping UnitedHealthcare, for example, if that’s their lowest-paying insurance, then it’s like, “I should do that. We’re on my list. Can I add that as important to do? I can’t get to it. I’m not enough because there are 80 other things.”

That’s where what I have to ask you. What would you recommend to someone in that position? They feel so overwhelmed. They’re listening to you and me talking. They’re like, “I want to join Rockstar Recruiter because I can’t recruit at all. An hour a week feels a lot for me or dropping UnitedHealthcare.” What would you tell someone in that position who’s so burned out and exhausted that they don’t even know where to start in terms of making a significant change?

I’m going to answer your question but that is something that people are weighing out in their minds. I do the same thing. You have all kinds of ideas for me in my show and my coaching. I’m upfront and frank with you. I don’t want to do that because I don’t have the energy for it. That’s not my lane. That’s not what I do. I know what speaks to me but for those people who are overwhelmed, I get it. You put me on the spot. This is the first thing that comes to mind. I try to nail this down as I talk to owners who reach out to me to consider coaching with me but were looking at an overview of their business.

I try to get down to 1 or 2 things that will make the biggest impact. It always comes back to The ONE Thing , that book by Gary Keller. What is the one thing that you can do such that by doing it, everything else becomes easier or unnecessary? When you have your admin time, some extra time or energy, it’s good to prioritize the long to-do lists in front of you and consider it. It helps to have that outside source like a coach or consultant to give you some greater perspectives because when you’re in the painting, you can’t see the painting. When you’re in the picture, you don’t see it as a whole.

You’re treating 30 hours a week and having a difficult time covering all your administrative tasks. If I were to simply give you two new physical therapists, what would that do for you and your business? They’re like, “That would change everything. I would be able to do it all.” That’s the one thing you need to focus on with any free time that you have.

Even if it’s 30 minutes or 60 minutes a week, you should be working on some form of recruiting and pushing that boulder down the road to get someone in your clinic ASAP. You have treatment notes that you need to do. You need to catch up on those. You’ve got bills to pay. Maybe they’re due next week or the week after. Let’s at least schedule and prioritize some time for the one thing that will move you further the fastest and do that first. The other small rocks can be addressed as they need to be. That’s the first thing that comes to mind. What do you tell people?

That was brilliant. I loved how you talked about this idea of the one thing. That’s one thing you brought to the table that was so powerful years ago. As you were talking, I was like, “That does make a lot of sense.” It’s interesting because when you were talking about that particular example of what PTs would be, I love the idea too of asking ourselves what would happen and painting different scenarios. You painted the scenario of two PTs that show up out of nowhere. I give you two Rockstar PTs that are going to do this. What does that do to all of your problems? It makes everything better.

That’s the thing and maybe that’s not the thing for the people reading. Maybe that’s something else but we have to look at the different angles. What if it is letting go of a certain employee? What if it’s a matter of a different referral source or whatever that might be? It’s pointing everything toward it but recognizing that it’s almost like the satisfaction we get from an accomplishment when we treat is the poison that kills our dreams because we hold onto that feeling, “I did something special.” To let go of that and focus on learning something that you suck at like recruiting is hard. Hiring isn’t hard. You’re not just good at it.

Holding on the satisfaction of your accomplishment is the poison that kills your dreams. You have to let it go and focus on learning something new.
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There’s a different mindset. I’m not saying we should beat ourselves up like, “I suck.” I’m saying that there’s a big difference when someone shows up at the table like, “I haven’t figured out recruiting but I’m committed to figuring it out.” We can create miracles in that guy’s world or girl’s world. When someone shows up and says, “I can’t recruit because it’s hard,” you’ve decided that so you don’t have to feel bad about what you can’t do but there are plenty of people, ATI is one of them, with hundreds of locations that are recruiting fine despite horrible stocks. The facts are the facts. How we frame it matters as much.

I love the idea of asking ourselves, “What’s the scenario? What’s the one thing that would happen to my business that would free me up or solve my pain,” and then being willing to let go of that sense of accomplishment in some way. If you’re small enough and the business is going to implode because you don’t treat, that’s one thing but if you’re renting a 10% margin and you’re going to go down to a 5% margin because you’re not treating, that 5% investment is not a loss. It is an investment. The return on that investment will yield multiples of time, money and freedom if we can start seeing it like that.

I don’t have anything to add other than commenting on what you said because that’s right. You also mentioned getting a coach, which makes a lot of sense. If you don’t even know where to begin, hire Nathan Shields. That’s what I say. It’s one of those things. He’s a wonderful human being. He’s got a great beard that I’m very jealous of. I’m old and I’m hoping puberty will come around the corner at some point. I can’t wait to grow facial hair. There are all these things people can do. People are reaching out more like, “Where do I get started?” You’re pointing people in the right direction, left and right. It’s great to see that because it is shifting the industry. We have to do more of it.

You also have In The Black billing and collection services. Tell me what’s happening there. What’s happening in the billing and collecting world? It’s the beginning of 2023. Usually, that’s always an issue. Are you noticing any trends in general? Tell us about the entity at large.

I have experienced that margins are getting thinner in private practice, not across the board. I’ve got many clients that are growing and killing it but there’s this growing observation of people. We’re starting to feel the pain of inflation. What I’ve learned is that people’s lack of understanding about medical billing creates a great deal of fear and challenge for us in that space because when things are down or there’s a delay, you never know. Is it the billing company or the billing person? Is it supposed to be happening? At best, it’s a case-by-case scenario where you have to do a lot of investigation.

I had a client, for example, who had a Medicaid issue. It devastated his business. He was not losing money but it rocked his world in a way where it started shifting what he needed to do to grow it. He could have, as I’ve seen others, freak out on their billing company but he never put our person to blame even though he wasn’t fully understanding what was happening. They worked together.

They got to speak with other clinics that were going through similar things because it was a statewide issue. It resolved. I gave him major kudos. I was like, “The way that you never gave up on your team but you still held everyone accountable was the balance.” Having fear is normal but do you want to puke on your team, the billing company or the billing person when you’re scared? What is that going to do?

“I’m disappointed in these results.” Do you understand the results? If you don’t, maybe give that person a chance to keep talking to them. If you’re working through a member of your team, you need to bypass that person and get directly in touch. “I’m showing up because I’m already burned out and pissed but help me understand.” This guy didn’t do that. He showed up from that place. We help everyone regardless but the reason we haven’t lost anyone is that we keep working with people on those levels but there’s a big delay in results when someone is upset and pushing on it.

That has been one thing. The other thing is PTs are changing EMRs. They are in a massive EMR change. If you’re reading this, you’ve probably had a demo somewhere. I did a YouTube video on my favorite EMRs. In The Black is officially partnering with one of the EMRs. It’s not to say this is the only one we’re working with but this is one that we officially put our stamp of approval on. That is MWTherapy. We love that company. We think they’re fantastic. I get nothing for saying that financially.

You don’t hear about MWTherapy out there when you’re talking about EMRs. It’s either WebPT, Clinicient, TheraOffice or Prompt. MWTherapy doesn’t come first to mind.

Most people have never heard of them before but they have been around for many years. I know why they’re not that popular in terms of their growth. They haven’t done the marketing the way that other larger groups have. They have been so hyper-focused on making the quality of the experience good that they have flown below the radar but they have also steadily grown. They haven’t gone through these huge spikes as others have and then dropped as others have. Their growth has been steady.

The reason I went with them and the reason we’re choosing to go with them is that when we work with an EMR, we have a specific filter that we like to work with as a billing company. We have the filter that you and I created back in the day. It’s the five things that we thought were important and the order of what mattered. Do you remember what our number one thing was that we came up with all those years ago?

I know what it is. I want to know what you think it is.

I know for sure because I talk about it all the time. You go first.

It was customer service.

Customer service is number one.

I remember that meeting surprised us. The number one thing that came up after all these values that we wanted to assess in EMR wasn’t the reports or documentation. It was customer service.

It did surprise us but the reason we landed on that was if someone has great customer service. We decided part of that was the ability to pivot toward the needs of the client. It was good lip service and action. It was both of those things. That was the thing. That’s where EMRs live or die. The better they are at the customer service piece initially and the longer they can sustain it, the better. When they grow fast, that becomes challenging. It becomes a matter of they don’t respond to me. This happens a lot with some systems. They say, “It’s already in there. I don’t know how to use it.” That’s not good customer service. Customer service is number one.

What Sharif has done over at MW is he has direct lines with most of his people but the bigger thing and this is what separates them, is that they make changes in a very quick way. When I say, “On the billing side, here are the five things we need to see differently,” they changed them. We brought over three clients from MW. We have never had a smoother process. Their collections never even had a slight hesitation in dipping. Usually, there’s a small dip initially.

Their collections immediately take off. They have cutting-edge automation around the patient experience, meaning online payments and scheduling. They have marketing systems in place and incredible metrics, a lot of which came from me. They have been very cool to help me, “This is what we want to see. This is what I want my clients to do.” He has been pivoting those things. The look of it is average. That’s the thing. It’s nice software. It’s not bad-looking. It looks nice. You look at some of the other ones out there. I don’t want to mention names. Some of the more cutting-edge ones look like that Apple feel. This looks like software. There’s nothing bad though. It doesn’t look outdated at all.

With the lack of marketing and maybe the feel of it initially, it’s in the white noise of all the EMRs but it’s a real diamond. Their customer service is amazing. Everything else has been fantastic. We have a number of clients who are changing over to them. In The Black billing, we won’t work with certain clients unless they’re in that system because of the complexity of their business. I’m a huge fan. They’re fantastic. I love other EMRs too but this is the one that has risen to the top. I am excited about them. They’re fantastic.

As you’ve dealt with so many different EMRs in your billing company, what’s the general issue that you’re noticing among them where they have a fault? Is it usually in the customer service part? I know the answer to that but is there customer service and anything else?

That’s usually their biggest sticking point. Business owners don’t care about their revenue cycle because they don’t understand it. They don’t understand that their office has one of the worst systems for revenue cycle management out there. It takes a full-time person to run through one of my clients and post charges, whereas that size of a client is times three in MW. I have another person doing three of our clients part-time. It’s three times the size for half the amount of work. That’s why we’re promoting them. We can spend more time not posting payments because we want to make a profit.

Business owners don’t care about their revenue cycle because they don’t understand it.
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What we want to do is spend our time doing the things that are going to generate more revenue for you, not the bare minimum things that have to be done. That’s a big thing. Customers circle back to it usually. PT owners at this point are starting to get savvier. They want more bells and whistles in their systems. They will go to their EMRs and say, “I want this.”

Either they don’t do it, don’t respond to the call or say it’s already in it. PT owners are getting pissed about that. They’re like, “Let’s find something that’s better.” I don’t believe anyone has got it figured out but what matters to us is someone who’s trying aggressively. They all are trying aggressively to fix it. I’m seeing quick pivots from MW in a way that our clients are loving them.

Have you dealt with any owners that are dropping insurance as we have talked about?

It’s inspiring. I was on a call right before this, which is why I was laughing. I had someone. It was an urgent issue but it turned into, “While I’ve got you on the phone, this is my strategy to get rid of insurance.” It was so cool because they were not even looking at dropping one. They’re trying to find a long-term solution to dropping all and going purely cash-based. Those conversations are coming up left and right. It usually circles exiting.

My coaching company MX helps people prepare their businesses to sell to get maximum value. At the end of the day, that’s where it comes up. They’re trying to decide, “Should I sell the insurance side of my business? Should I pivot it?” Most people are starting to pivot, which is great. In my opinion, I don’t have a strong push either way but when people are in their practices and they’re starting to drop those low-paying insurances, they’re starting to realize, “I am so much happier. I’m not working as hard. I’m not working underneath this myth that I have to serve everybody.”

None of us can serve everybody. Why don’t we serve the people that promote your profits, the industry and their health? Why don’t we do that? As they do that, they start getting more of a vision around it. The new generation I coach is looking for ways to develop cash-pay side hustles or do cash-pay businesses. The industry is shifting. I hope it shifts faster so that we don’t disappear.

As the new generation of PTs look for ways to develop cash-pay side hustles or businesses, the industry will continue shifting.
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It goes back to simply the fear of change, “This is how we have done it for decades. It has worked out.” We’re at this point. We have to think of different thought patterns and thought processes. That change can take time and be difficult for some people. Maybe it’s a matter of some of the older generation fading out and the newer generation and thought leaders coming in. That’s what it takes.

There’s a big part of it that’s true. What’s interesting is Seth Coulter who’s going to be at the town hall meeting in April 2023 is not a spring chicken. He’s in a stage of his career where he’s an OG. He’s one of the savviest change-promoting guys. I don’t think it’s always those exact lines but it’s more accurate to say probably the old-school mentality is typically tied to how the older generation is shifting out. We are part of that generation. People our age are still the ones who are terrified to make a change even though they’re miserable but you and I because of our experience have started shifting out of that as a lot of other people have.

The newer or younger kids in school are like, “We’re going to charge you $170,000. Maybe you should open your practice instead of telling you that you’re weird for wanting to do so as they told me.” I had a teacher say, “Are you in it for the money?” I was like, “Yeah. Aren’t you? It’s not why I’m doing it. I’m doing it because the greatest feeling in the world is helping a human being reclaim their life but I have to get paid.” I thought that was the weirdest thing and I still do. People think that way.

There is that tendency on the academic side to demonize its profitability.

I could go off on that but I won’t. It’s funny how that happens.

Maybe there is a greater role on us not to just go to these schools, recruit and develop some of these graduate students but also to promote that idea, “This is what we’re coming up against in the industry. Give me a chance please to talk in front of the graduate students about what it’s like to own a practice with physical therapists who are asking for $150,000 salaries and how those financials don’t work out. Even if you see one patient an hour and get great results, you do not deserve a six-figure salary. This is why.” I would love to have that conversation with anyone who’s an academician and they want me to come in and say that. I will be happy to do so but I don’t think I’m getting any calls.

I got to the point where I was starting to demonize a lot of the academic world until I sat on the plane next to this wonderful dean of a university in Arizona. We were flying to CSM together. We started chatting. She was incredibly entrepreneurial but she admitted it. Everyone has their role in this game. Entrepreneurs are big problem-solvers and thinkers. We are the ones who are going to bring profit to the table in a way that’s going to promote and save our industry. It’s not a slam on them. There’s a subset of academic people who legitimately are causing that.

When you say, “We should talk to the university students and speak like that,” that’s one of the key elements that people don’t understand when they join Rockstar. One of the first things we teach is that you’re not going to speak there for recruiting. The product is somebody who wants to join your practice but if you show up there to serve the industry in that class by teaching something that changes their lives, that’s the only way to connect because people can feel our intentions 1 mile away. Frankly, they can feel our desperation.

Ask any beautiful woman who has ever shown up on a college campus. She can feel the desperation and smell it. The same comes from students when we show up and we’re like, “I’m here. I have to get three. I’m missing five patient visits. I have to be out of here in 30 minutes. I need two strong leads. I don’t know what I’m going to do.” You’re not going to do very well but if you’re there like, “This is my chance to treat the industry versus treat my patients,” the product is someone who wants to work for you and who doesn’t want to work for that person.

I love that. That’s a cool mindset. You spent plenty of time talking to us about things happening in the industry. If people want to get in touch with you, how do they do it?

Through you, always. If you want to talk to me, talk to my buddy, Nathan. He will funnel you my way. If you want recruiting help, Rockstar Recruiter is amazing. We are in the early stages. I’m promoting Rockstar Director. Rockstar Director is the sister company. It’s a program I’ve been developing to help PT owners find someone else to mentor and grow the directors into becoming independent entrepreneurs of your business so that you can focus on the business and let them focus on it. There’s In The Black medical billing.

Why didn’t we spend the entire hour on that?

Next time.

We will do that because that’s super cool.

We will have Michelle Bambenek on that call if we do that because she is my partner in that.

I had her on a few episodes ago because she provides such a valuable niche in coaching and consulting that you and I have never seen before. She will come into your company and train your clinic directors for you. I had her on the show a number of episodes ago simply because of that. It was so unique and cool because as owners, how do we teach somebody to be like us? It comes naturally to us but how do I make a system and process around that?

It’s so funny because you and I can talk to our people and they get a certain buy-in. Michelle comes in and says the same thing and they go, “I get it.” They start taking ownership of it. I call her The Clinic Director Whisperer. We have been talking about this program for a number of years. She’s a partner in MX. We finally are at a point where we have everything structured. We’re putting it out there. We’re taking a beta group through the group. We haven’t started seeding it yet but we are looking for interested people.

If you’re interested in learning more about that program, reach out to Nathan. We will put you on our waitlist for more information and then you can opt-in to be one of our beta test users. In The Black has been going great and growing. If you need medical billing help or any concerns you have with your current group and then if you’re looking to exit, I’ve got a coaching group. Michelle is a part of that as well. We are looking at helping your company maximize its value before you go to market. That’s what we got.

Do you have a website for MultiplExit?

I do.

In previous episodes, you didn’t have one yet. I want to see if you do so people can check it out.

It’s simple.

I want to make sure people know that MX stands for MultiplExit. You’re talking about exits at a greater multiple, thus MultiplExit.

The tagline is, “How to get maximum values for your life’s work.” That’s the thing. At the end of the day, we all exit. What does all of this hiring of people and creating directors and medical billing lead to? It leads to our inevitable exit even if all we want to do is sell to our employees. We want to make sure we create it in a way that it’s easy to transfer and worth the most possible. That’s what we do. People go, “You’ve got your hands on a lot of things.” I don’t feel like I do. All I do is help people start, scale and sell their businesses in terms of prepping to sell. That’s the world we live in. It’s a lot of fun.

Thanks for taking the time. We talked about a ton of stuff. Thanks. I’m sure it was an unwelcome distraction from your Taylor Swift thoughts.

I’m so obsessed. I could name two of her songs.

That’s two more than I can name. That’s great. Thanks. It’s good talking to you.

You as well.

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The post The Challenges Of PT – Recruiting, Facing Changes, And Emerging EMRs With Will Humphreys Of Rockstar Recruiter appeared first on Physical Therapy Owners Club.