Use Virtual Assistants (VAs) To Improve Productivity With Adam Robin Of PT Owners Club Coaching

With inflation, salaries, and reimbursement trends working against PT clinic owners, it’s imperative to consider cheaper solutions to get more done and maintain/improve profits. Virtual assistants (VAs) can be a valuable tool to use and accomplish this, specifically. In this episode,  Adam Robin, PT  and Nathan Shields, PT share with private practice owners how they have found and used VAs to improve both personal production and production of teams in various departments – marketing, billing, admin, front desk, etc. Tune in now to learn how to strategically delegate tasks to VAs, so you can focus on your core responsibilities, deliver quality patient care, and drive growth in your clinics.

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I got my good buddy and fellow coach in the business, Adam Robin , with me. Adam, how are you doing?

I’m doing good. How about you?

I’m doing good. If you haven’t tuned in to the previous episode that I had with Adam, Adam has joined me on the Physical Therapy Owners Club Podcast and coaching services. He is a fellow coach for PT owners to help you gain more wealth and freedom. We’re talking about different topics related to the PT industry and how we approach things. If you tuned in to the previous episodes, we’ve talked about recruiting physical therapists. Last time, we talked about your specialization and niche in pediatrics , your experience there, and how to grow that. We’ve had some good topics to discuss and good discussion .

Now, I want to talk a little bit about something else that you’ve done that’s rather unique to you . I’d be surprised if a lot of physical therapists are taking advantage of it nowadays. Your utilization of Virtual Assistants or VAs in physical therapy space. I have used them myself here and there, but you’ve been working with VAs for some time now.

I want to pick your brain and see how physical therapy owners can utilize virtual assistants to their benefit and take some things off their plate s, especially as we’re looking at this market . If we were paying $15 an hour to a front desk person, that was golden. We could find some amazing people at $15 an hour. That’s not the case anymore. Looking for other options is great . I think it’s timely to be talking about this. What made you look for VAs in the first place?

If I think back, the first thing that I wanted to get better was my marketing system. I had bounced around a little bit with a few different marketing agencies. Some of them were great. Some of them weren’t so great. At some point, I was like, “I’m going to learn about marketing. I’m going to read some books. I’m going to learn and figure out how to communicate.” Once I started learning that, I was like, “I think I can do some of this.”

When you’re talking marketing, which bucket are you talking about? Are you talking about social media? Are you talking about relationships with physicians? Are you talking about current and past patients?

I would say more social and relationships with current and past patients because there are so many different communication channels that you can utilize when you’re trying to increase awareness. The hardest one to do is in person. It costs the most.

There are so many different communication channels that you can utilize when you're trying to increase awareness, but the hardest one to do is in person.
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Time and energy.

You can make calls, email, fax, text, or message on Facebook and LinkedIn, Those are all things that can be done virtually. That’s where we started. I had a colleague of mine share their experience with how they utilize VAs. I was like, “Just like anything else, I don’t know a lot about it, but I’m going to roll the dice and learn.” That’s what happened. I learned.

If you’re going to try it, the cost isn’t that heavy. You can get some of these people. You can get on some contracts that are 10 hours to 20 hours a week. You pay some of that upfront . You have to spend a little bit of time training them , and you’re going to want to review their product before it goes out to the mass market , but you don’t have the overhead in terms of taxes. If you work with a company, sometimes the companies can bring you multiple applicants. You can sift through those and assess them. I love that you first went to marketing because, in my VA experience, most in the medical profession is related to utilizing VAs for the billing side of things.

I used my VAs for insurance verifications and authorizations. There was a time when I was subletting from another physical therapy clinic for my diagnostics business. I utilized the VA to do the scheduling, reach out, contact referrals, and all that kind of stuff. It was helpful to not have that additional overhead, but it’s not a lot of worry and concern as long as you’re training them well.

There are some overhead expenses, but the first interview that I had with a VA went something like, ” I don’t know what I’m doing. This is my first time doing this. You want to give it a shot?” I don’t know if you remember the previous episodes. It was like getting curious. Have some fun with it. Don’t set too rigid of expectations. Try to find you a VA that’s open to learning and growing with you. Who knows that might be somebody that turns into a lifelong employee. That might not, but within 90 days, I felt good and comfortable about how I could utilize their service and expertise. Also, I find a lot more convenience in my life. If there’s one thing I’m willing to pay for, it’s convenience.

It gives you more time, freedom, and ease of mind.

If it gives me more time and bandwidth, or if I can relax a little more and think more about bigger issues, tell me where to sign.

I’ll pay for that all day long.

That’s right because that’s good for the business. If that’s good for the business, then it’s going to make you some money. You might not know exactly how it’s going to make you money right now, but you’re going to figure that part out.

I want to mention this one thing before I forget it because we just talked about it. In that marketing division, our good friend David Ban uses virtual assistants for a number of things. One of the things that he uses virtual assistants for is physician relationships. He will have his virtual assistants call out to the physician’s offices. He gives them scripts if he has topics that he wants them to follow up on . He gives them a list of patients that the physicians have referred recently. He does use them for that last bucket that we didn’t touch on, as for physician relationships.

I like to hold that personally a little bit more or at least have someone to be in person, but that is a possibility. I wanted to say that, but I’m sure people out there are like, “Maybe I’m bought in. I want to get a virtual assistant. I’ll try it out. I’ll have some fun and see if it can work.” Where did you go first? How did you find your virtual assistants?

I’ll send you a link to the best YouTube video that you can watch. It’s about an hour long, but it’ll literally break down how to find, how to hire, how to hold them accountable, and what computer programs you need. Everything. I started there. I watched that video.

Just like everything else. Just like fixing a car, it’s on YouTube.

You got to learn it from YouTube. Pick ten videos, watch them, make notes, jump in, and start swimming. It is important to know that. I believe that video in particular is an informational video. That is a video that highlights a platform where you can hire VAs. I think they’re trying to lead you to purchase a subscription to hire. I don’t have any affiliation with them or anything. I do use them, but it’s not somebody that I work with. I don’t have any affiliation with them.

I know Will Humphreys uses them a little bit. He has found a way to go directly. Honestly, you’re talking about working with people who are typically in the Philippines or maybe India. You can weed them out, but some of their English is pretty good. You can’t tell too much that they’re foreign or maybe foreign-born but not living foreign. He has found a way to get to them directly. I don’t know if I would recommend right off the bat how to post ads to virtual assistants in the Philippines. I would recommend going with a company first before you feel comfortable, wouldn’t you?

Probably so, but you know me, I like to do things the hard way.

You’re willing to jump in with both feet. That’s a little bit different than most PTs.

I actually did the opposite. I didn’t work with an agency. With that being said, there have been times when I thought about maybe it would be better to work with an agency. I got lucky because I hired the two best virtual assistants. These guys are amazing. They’ve been with me for three years. I’m never getting rid of them. I got lucky there. I can see how, if you go the direct access route, you might have to weed through a few to find that A-player and figure out what you want. Those are a lot of things that the agency can help you with right out of the gate.

The agency helped us . We told them, “This is what we’re looking for. This is the job description. This is the experience we would expect them to have. ” They g ave me 3 to 5 candidates that we could interview. We assess ed their personality over the phone and their English . We talked to them about their experience, and how they preferred to communicate. You can do the same thing on your own. When some of them didn’t work out, it was as easy as calling the agency and saying, “Can you give us a couple more opportunities or a couple of other candidates to fill this role?”

You don’t even have to train them because the agency makes sure they’re trained in stuff like that.

They typically have some experience in whatever job you’re talking about , whether it’s billing or marketing . They usually come forward with those candidates for you and you don’t have to weed through them. There is a way to do it, but what’s cool in the way you talk about your guys is that they become team members. They’re not just some guys that live in the Philippines . You consider them part of the team.

They’re on my website. They come to the team meetings. We talk about purpose and values. We set goals together. They are just as part of the team as the physical therapists are. They have needs and goals just like people you work with in-person.

For people who might be a little bit judgmental about working with foreign VAs, I hope this doesn’t come across that we’re taking advantage of them. In these situations where we’re providing a job for them that could be $10, $12, $15 an hour. $15 an hour for them, they’re living high essentially. I know from experience offering somebody a $ 12-an-hour job down there in the Philippines was enough to make them shout for joy or tears of joy, and that kind of stuff. I want to put that disclaimer in there because there are opportunities to serve people in other parts of the world like this that can be a benefit to both of us. It changes lives.

I don’t have hard numbers in front of me, but I did have a conversation one time with a physical therapist in the Philippines. She wanted to leave her profession to be a VA with us because they get paid $3 an hour or something like that. It was low. The guys that I have are anywhere between that $9 to $12 an hour range. They have families of 4 or 5. They have new cars. They live in a house. One guy has a motorcycle. Their kids go to school. They have a very good quality of life.

There is that little bit of a mindset that you have to learn a little bit more about because I even had it myself when I first started off. I’m a physical therapist so I love people. I don’t want to take advantage of them. Once you learn a little bit more and you’re like, “This is actually a win-win. We have room to grow together.”

Have you worked with or talked with anyone that has utilized VAs in other departments? We talked about billing. I know our good buddy David Ban in Chicago. His whole billing department is his VAs that he leads out. He hasn’t turned it over to a billing company that has VAs. He has a VA that’s in charge of hosting the claims. Another one that’s for collections. Another one that’s sending out the claims and cleaning stuff up. He becomes then the billing manager. Do you know of anyone else that’s utilizing VAs in different capacities outside of marketing and billing?

We have an operations manager. That is his title, operations manager. He’s in charge of all the operations of the whole clinic.

You do?

We do. We have two.

What are their roles? What are they doing?

We have a marketing assistant, and then we have an operations manager. What I’ve learned is that part of the job of the owner is to make sure that you have operational capacity. You want to make sure that if problems come in, you can spit them right back out quickly. You could solve problems very well when you have a strong operations team. When I hired my VA, I explained that to him. “This is what I want to create. I want to create an operational machine.” We built out the policy and procedure. We built out all the training for our therapists and front office.”

Part of the owner's job is to ensure you have the operational capacity to spit back the problems quickly once they come in.
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Is this something he worked with you on?

Yeah. Now, he helps me with recruiting. He helps me with all kinds of stuff. It’s pretty much anything I need help with.

You call him the operations manager. If you’ve read Rocket Fuel or Gino Wickman’s Traction , he has visionaries and integrators on the org chart. Would you say he’s more of an integrator if you were to put him on the org chart for your visionary role? Is he like that?

He’s an integrator. His job is to take my vision and turn it into something that makes sense. I’m good at the vision. I like to see and climb the hill, but I don’t know how to do it. What he can do is listen to me speak, put it into words, make it sequential, and make it step by step.

Go into the weeds a little bit, how is he helping you develop policy and procedure?

Anytime there’s an issue, we list the issue. Our mission is to develop policy and training to solve that issue so it doesn’t happen again. That’s what he does.

Are you on a Zoom call with him and you’re talking thi ngs out? Is he doing all the typing kind of thing? Is that what you’re saying?

Every week. It’s like, “Let’s pull up the issue board. Which one of these is the priority this week? Let’s review the policy. What does it say? What is the thing that we need to change to make sure that this issue doesn’t happen again? That’s a good idea. Let’s try that. Let’s follow up next week.”

You’re brainstorming with him. He’s typing this up. Who comes up with the issues? Is it either of you? Does it matter?

The issue is typically funneled to me, but then I redirect them to the issue board. It’s like, “Let’s go to the issue board with it. We’re going to meet on Tuesday, and we’re going to figure out which one is which.”

I love that . You have an issue board that you’re tackling every week , and you have someone helping you do it. What is his interaction with any of the team on-site?

He sits in on those meetings. He sits in as a part of the leadership meeting. He also plays a key role in the onboarding process. We set Zoom calls with him because he manages the timesheet. He’s making sure they’re getting access to the training, checking off that onboarding checklist, and guiding them through that process.

The beauty of that is you’re not giving it to another PT and taking them off the floor in treating. He can do that onboarding, go through the checklist, and allow your providers to stay productive. He’s typically a clinic director. He might do something like that if it’s not the owner themselves.

There is still a little bit of we have to have that person on site to manage that, but it’s not nearly as high of a degree. We don’t have to take a week off to train somebody. You can take half a day off, train them on the process, and then check in twice a week. It’s more efficient, less hands-on, and Kevin gets to do what he does best. Everybody wins.

That’s interesting that you would find someone in the Philippines whose unique ability relates to a physical therapy clinic in America.

He is a clinical psychologist. He’s a psychology expert. I believe he has either a master’s or a doctorate-level education. He’s a top-notch guy. He’s a professional.

He wasn’t just doing construction last weekend and you brought him on board. He has a background.

He knows what he’s doing.

I almost want to go further into the integrator role, but that’s not the topic for this discussion. The fact that you found a VA for your integrator role. I’m glad we hit on it because I was thinking there are VAs out there that could help you , depending on how you classify it. Some people might have hauled Kevin an administrative assistant, or my secondhand man, or whatever you want to call him. You call him the operations manager because he’s your second brain in terms of implementing processes and procedures. At your stage, that’s your job as the CEO. I’m glad that we covered that topic.

There are other things that I’ve heard about where you can utilize a VA . I know a friend of mine who’s utilizing a credentialer in Pakistan of all places to credential all of his physical therapists. The guy knows the routine and it’s a flat rate per contract or whatnot. It makes it simple and easy for him to get it off his plate and everyone else’s plate because credentialing is a pain in the behind. The other thing that I’ve heard recently is about utilizing virtual assistants at the front desk. I’m going to do a n episode in the near future with a company that provides that support. Have you considered it? What do you know about utilizing virtual assistants at the front desk?

I’ve heard about it. I know you had Dee Bills on the show. We’re going to have to get her on here and figure out what she thinks about it.

She’s the one that referred me to this virtual assistant company. Isn’t that crazy?

I was a client of Dee. She showed us the ropes and she’s awesome. She would probably be the first person I would go to to ask about that to see what piques her brain. I know anything can be done. I’ll put it to you like that. I’m a believer that pretty much anything can be done. It’s not something that we’ve focused on because having that in-person for an office is a pretty important part of our company, but I think that it can be done. You were telling me a little bit about you can have one person managing multiple clinics virtually. There are a lot of perks to that too.

The closest thing I found to it was a conversation that I had with Tom Dalonzo-Baker . I’ve interviewed him a couple of times on the show. I need to have him back on. He had a front desk person that was amazing like five-star . He loved her to death . She has high KPIs and always producing. She said, “I want to work from home.” He’s like, “I don’t know how we can do that.” She said, “I want to do it. Will you give me a chance to try it?” He’s like, “You’ve earned enough credibility, we can try it.” She worked from home . She got to the point where working from home, new patients that came to the office had already paid their copay before they came for the initial evaluation , and scheduled their full plan of care before they met the physical therapist. It can happen.

It can totally happen. If you’re a decent business owner, you have to have a little joy and excitement about looking at challenges and trying to figure out ways to make it happen.

We talked about this last time. Especially as it pertains to helping your team members achieve their goals , and that you’re meeting their desires and their purposes.

You’re no longer a physical therapist. You are a coach. You don’t own a physical therapy company anymore. You own a coaching company and you coach others how to run a physical therapy company. That is the conversation I recently had with my leadership team, and it has been a huge mindset shift. We are not focused on our clients. That’s what physical therapists do. We’re focused on them. We’re looking at the employee journey. We’re looking at employee satisfaction. How do we help them get what they want? The VAs can help you with that.

Can you imagine Tom’s situation? That woman is committed. If it’s her idea that she wants to work from home and Tom gives her that chance, who’s going to make sure that it’s successful? She is.

She has to.

She’s going to go extra hard to show, “I said I could do it . Now I’ve got to bring it. I’ve got to bring the goods. ” It’s impressive when you let people do things . They might be a little bit off course, but if you let them shine in that position, they can do great things and things can improve. I’m looking forward to more conversations about that, especially as it pertains to the front desk. We’re talking about VAs. However, as it pertains to the front desk and if people are considering the utilization of a VA, it’s an opportunity that could work. As long as it aligns with you and your company, and you find the right person , it could work.

We have to figure out how to get to the million-dollar mark, have the operational capacity to get through there, and keep our employees happy.

With a good profit margin.

That’s freaking hard to do. You’ve got to get creative. Once you get on the other side of that million-dollar mark, then it’s like, “Now I’ve got a little money. Now we can be a little bit more ideal about things.” Finding ways to leverage things like VAs, or having virtual front office people, or having the virtual person do the billing. I don’t want to use the word cut corners because you’re not cutting corners, but you’re utilizing non-traditional cost-saving methods to operate your company. You got to.

Utilize non-traditional cost-saving methods to operate your company.
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Your responsibility ultimately is to your household, but the clinic needs to feed the household of profit. As reimbursements are going down, we’re forced to look at these options. You see this in different areas for PT owners as they’re looking at the multiple departments that they have to oversee. They might drag their feet because they don’t know how to manage that department. When I say that, off the top of my head I’m thinking, “I didn’t manage my billing department. Even though I had it on site, I didn’t manage it very well or at all and lost lots of money because I didn’t know how to manage it. ”

Also, physical therapy owners initially might think of the idea, “If I hire a front office manager, they can do all the managing and we can abdicate our responsibility as CEOs.” I love what you’re saying that that’s far from the truth. I learned that the hard way as well. My responsibility is now to oversee a front office manager , as well as everything else. That’s your responsibility as the owner of the company. When it comes to VAs, it’s a matter of learning how to manage them. What are the nuances? If you’re willing to put in a little bit of time and tuition in terms of money, energy, and time, then you’ll learn how to manage them, just like any other employee.

You would be amazed at how many new opportunities you would come to realize if you would take one day off of work and watched how to hire a virtual assistant on YouTube all day. Write down everything you learn. The next day, you’re going to be like, “I can do this.” Your whole mindset will shift. People make the mistake of, “I’ll just figure it out.” They don’t carve out that time to be like, “I need to carve out the time to learn.”

Get some baseline knowledge.

Give yourself permission to go into your office, turn your phone off, turn off your emails, watch some YouTube, and try to have fun. A day later, you’re going to be like, “This is not even close to how big of a deal as I thought it was. I’ve got ten action items I can take right now.” Do that for any problem you’re trying to solve.

There are opportunities out there to leverage people. We leverage not quite virtual assistance, but we’ll get on Fiverr and Upwork to get creative marketing support. If we’re sending out a newsletter, we’ll put it up on Fiverr for auction or bid. We’ll get people to say, “I’ll do it for you.” Fifty bucks later, they’ve given us all the images and the fonts. They made it nice and pretty. It’s the best $50 we’ve ever spent so that we didn’t have to do it ourselves. We then send it off to the printer. There are lots of opportunities out there to utilize some of these things so that it increases our bandwidth . It can improve our ability as owners. Now, we can start moving our energy and time into other things that are more unique to us that will benefit the business.

Probably, we’re bringing it all in right now. Ultimately, what we were trying to do is get the owner to a place where they feel excited about their work. They’re in their unique zone of genius and they’re doing the work that they love. They can see out ahead a little bit further. If you can build things around you that help you skit into that state more often, then you’re going to freaking crush. If you feel like there are things right in front of your face, you’re dodging all day long, and you feel anxiety, depression, and all these uncomfortable things, at the end of the day, you’re exhausted. You’re not making progress. You’re spending your time doing the wrong stuff.

You’re giving all your energy to the business , and now you have nothing for your family when you get home.

Nothing, which is the most important thing in your life. A VA can help you change your life. It definitely changed mine, for sure.

Thanks for taking the time. If you want to talk to Adam and me about your business to see if we can help you a little bit, go to PTOClub.com . You can sign up for or schedule a discovery call with us. We’d love to talk to you about it. If you want to reach out to Adam, how do they get in touch with you?

Shoot me an email at ARobin@SouthernPTClinic.com or check us out on the Facebook Group. DM me and let’s talk. Ask me some questions. I’m an open book.

You can reach out to me at Nathan@PTOClub.com . Schedule an appointment to talk with us. We’ll be happy to talk to you about your business and where you might need some help if we can help. Check out the website. Some of the notes are going to be on the website, PTOClub.com , for this show, especially the YouTube link that you are going to share with us . Adam , thanks for joining us. I appreciate it, Adam.

Yes, sir. Talk to you soon.

During his spare time, Adam enjoys spending time with his family and friends. He enjoys challenging himself with an eager desire to continuously learn and grow both personally and professionally. Adam enjoys a commitment to recreational exercise, and nutrition, as well as his hobbies of playing golf and guitar.

Adam is inspired by people who set out to accomplish great things and then develop the discipline and lifestyle to achieve them. Adam focuses on empowering and coaching his team with the primary aim of developing “The Dream Team” that provides the absolute best patient experience possible. He believes that when you can establish a strong culture of trust you can create an experience for your patients that will truly impact their lives in a positive way.

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