Creating Amazing Culture That Fulfills Owners, Engages Teams, & Drives Itself With Adam Robin, Jim Floyd, And Nathan Shields – PT Owners Club FB Live Event

How do PT owners generate a positive culture they can be proud of? A fun, exciting, and productive culture – something they always dreamed of upon opening their clinic. In this episode, Jim Floyd from Ascent PT, with Adam Robin and Nathan Shields from PT Owners Club Business Coaching, discuss how they created an amazing culture that fulfills owners’ dreams and makes coming to work exciting. They discuss the power of developing habits and systems that amplify exposure to core values, enabling individuals to manifest the desired outcomes. Adam and Jim emphasize the significance of clearly communicating values and vision, helping others understand and align with the organization’s goals and objectives. To get an idea of the exceptional culture of a PT business, watch this episode with Jim Floyd and Adam Robin.

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In this episode, we’re talking about culture and the employee experience. Last time on the show, we had Will Humphreys on, talking about recruiting. There was some huge value in that. It’s something that a number of people got some great insight from. There’s that great phrase, “Culture eats strategy for breakfast.” Focusing on culture, especially according to Brené Brown and her works, culture is a huge part of what we’re building, especially if we have a defined purpose.

It relates to not only the recruiting efforts because culture can bring those people who are like-minded into our company but it also keeps people there who might say, “I could go other places and make more but I’m happy with where I’m at simply because this culture is amazing.” I’m glad that you brought up this topic, Adam , to talk about. Tell me a little bit about what your thinking was behind introducing culture and the employee experience.

I love the phrase, “Culture eats strategy for breakfast.” It’s a hard thing to convince yourself of when you’re in the thick of it. When you’re in the thick of business growth and being an owner trying to figure out and get your ducks in a row, for whatever reason, the way our brains work, we think, “If I can get this organized and implement this strategy, and then I can get this tactic dialed in, I’ll have the freedom that I want. My team will align with me,” and so on, enter ideal outcome.

I tried that strategy and I’ve been to the end of that road. Did you know what I found? I found burnout, turnover in my team, poor outcomes with my patients, stagnant business growth, and all the hard things that come with business ownership. I then started embracing this thing called culture and leadership. I started focusing there. I said, “Let’s change the leader. Let’s get the leader dialed in and bought into leadership and culture.” Whenever I started focusing there, things changed for me.

My team started raising their hand and saying, “I want to help.” “Let’s start this new program, make a bigger impact, and do X, Y, and Z.” I found that during that journey of business ownership, there is that point where to get to the other side, you do have to start focusing on your culture and leadership abilities. I feel like that’s a stuck point for a lot of people. I then came across Jim’s stuff. He is somebody I’ve known for a few years. We are aligned a lot on the culture side of stuff. I’d love to pick his brain and see what he’s got going on.

Jim , introduce yourself to the group and a little bit about yourself but also, your thoughts about what we’re talking about.

I am a practice owner in Columbia, South Carolina. We have a rapidly growing clinic and lots of DPTs on board and many more coming. From the start, I have always been more focused on culture. I’m a very organized person, all that stuff too and that is important. I like having a connection with people. Learning from different places where I worked before opened up my thing. I recognized things that I liked and didn’t like.

One of the big things and common themes for the places that I enjoyed working at was a strong culture of support, enjoying coming to work, what you’re doing, and having that passion behind what you’re doing. I’ve leaned into that role within my company of being that visionary leader and being very clear about what we want to achieve with our company and what we’re doing for our profession. Also, having that be the driver of every single thing that we do daily and all of our goals, our goals as a company, and our goals for ourselves. Having those things be the big things that push and help us to try to get better at what we’re doing every day but try to provide the best environment possible to be able to do that.

I can think back to being a younger owner. I’ll default to this. We want to push for a certain KPI to improve. We want to implement certain programs and protocols. I find myself not talking about the vision, purpose, or culture. Do you find that that came naturally for you? Another question to that is, do you have those conversations prior to having the KPI or the new program conversations?

It came naturally to me. More of the passion and all that stuff was easy because I’ve always been pretty passionate about what we do and how we do it. Incorporating KPIs and those things was something I needed to start to implement and it is interesting. My thoughts on that are that those things are intertwined.

If I’m having a conversation with our staff about productivity, what we need to bill per visit, or anything like that, it’s not a conversation of, “We need to do this for revenue’s sake,” kind of thing. One of our big goals is we want to show there’s a better way to do everything that we’re doing and show patients that there are better options than a cookie-cutter PT.

There's a better way to do everything we're doing and show patients that there are better options than just a cookie-cutter PT.
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That needs to be reflected across the board and in everything that we’re doing. Even with how we bill for a visit, all those different types of things, I’m always going to relate every one of those metrics to the overarching thing we’re passionate about. That makes that conversation easy to have, even if it might be something that might be a little bit more of a challenging thing that we might be a little bit worried about.

If I’m able to relate that to what we’re passionate about as a company and what our goals are and all that, it helps to get that understanding and the reasoning why we have to do certain things and all that stuff. It’s not just, “We want to make more money.” It’s more like, “We need to do this so we can continue with our model. We can continue to show people that this is a different way to do it and this is how we’re going to continue to push those things.”

You’re verbalizing what the default reasoning will be for the readers as you’re talking about KPIs like, “You’re only doing this to make money.” If you’re not willing to draw the connection between purpose, the program, and how it’s better for the patients and it’s a greater fulfillment of the purpose of the company, they’re going to default to, “You want to get greater profit to make it easier on you and your lifestyle so you can go on vacation.”

They’re going to default to that from my experience. Do you mind giving me an example quickly? Let’s say the arrival rates in your clinic are poor. You’ve got a 75% arrival rate. Maybe give me an experience of an actual conversation that you’ve had with your team. That might even be better. How would you approach that, not in total but what would the structure or the summary of your conversation be?

We can use arrival rates. That’s always a fairly common issue across the board. That’s going to be something where we want to look at it if we can figure out some of the reasons why. If we’re going through that conversation too, first off, we want patients to be able to come because that’s how we’re going to help them get better. If our big overriding purpose is to be able to help as many people as we can and show them that our brand, the way that we’re doing things is what we believe is the way it should be done, then we need them to come in to be able to do that.

We might look at a little bit more of, “If we are having some issues with a certain patient population coming in, maybe a certain therapist, or anything like that, let’s dive a little bit deeper on, ‘Have we communicated values appropriately both with that therapist? Are they on board and understand the way that we want to approach things? Are they down with that? Have they done a good job of communicating the way that we want to approach things with that patient too?’” Also, establishing that expert level care and having that passion exude through to that patient of what they want to be able to do.

Ultimately, it comes back to a bottom line kind of thing too if we need that utilization higher. However, it doesn’t need to be a stark conversation of, “We’re only at 75%. We need to be at 90%.” We need to do that. As long as we can relate it to those things or are overarching ways of doing things and passions, it makes it a lot easier for all of our staff to understand and be on board. We lean into those things too. Anytime, we’re going to approach things with passion and a lot of belief in the way that we do it. It makes it so much easier to ignite that within a patient that we’re seeing or ignite that in one of our staff too.

You start with, “This is the why. Are you clear about the why?” “This is what we need to see.” We’ll also show you the how if you’re not clear on the what. However, if we’re not clear on the why, then maybe we need to focus there and get on the same page. How do you go about some of those similar conversations, Adam, or do you want to touch on something else you said?

My word is rally. We’re going to rally the team. We’re going to rally together. I have this young therapist who we’re training to be a clinical director. Part of that training is helping that person lead other members of the team. I had this conversation with him. We have this new PTA who felt wasn’t quite giving the quality of care that he wanted.

I said, “How are we going to rally her together?” Essentially, what we got down to was, “Let’s share the ideal outcome and give her an opportunity to give you ideas and help you build it.” “My goal is I want this patient to leave here happy with the goals met. I want her to refer ten people to us because we’re so amazing. That’s something that’s important to me. Are you interested in helping me with that?”

It’s giving her an opportunity to elect to be a part of your vision. She has to raise her hand and say, “Yes, I want to be a part of that.” It’s like, “Great. Will you help me build it?” “Yes.” “I’ve got a pen. Give me three ideas we can have, 1, 2, 3. If you have raised your hand, you’ve decided that you want to be a part of this and you are agreeing that this is the action item. Am I understanding you correctly?” “It’s a great idea. Let’s follow up in a week and let me know how that goes.”

That is leadership. You’re starting with the end in mind, painting the vision, giving her an opportunity to decide, and letting her build it. You’re making her think that it’s her idea. I never talked about stats once and the next month, the stats and culture rose. They get excited, “We did it. That’s awesome.” “I told Mrs. Smith about it and she referred a friend. Look at our arrival rate.” That’s the mission. That’s how we do it. It starts with the leader.

One of the mistakes that we all make as we’re finding ourselves as a leader is it is a lot easier to tell somebody to do something and it is a lot simpler process but that’s not going to be constructive at all. I love that approach of having that staff member be actively involved in formulating a plan for how we want to do it. We can guide as needed and help facilitate that but ultimately, having them have that on us to put the things in motion that need to happen to achieve that goal.

I love your word rally and how you use that with the team because it gives a visual. It is a synonym in your definition of its alignment. “Let’s get them aligned.” It’s easy to get them aligned if the leader is first clear on what that purpose is. It starts with the leader. That’s a default or a problem that you see in most owners if they’re not clear. They haven’t taken the time and the brain energy.

They’re focused on the structure of the company and the KPIs. They haven’t spent the time on the purpose of the organization. Also, to get more specific about your examples in arrival rate, they’re not focused on the purpose of each visit or the product may be of each visit, and the product that they’re expecting to get out of each new patient.

The product of a new patient is someone who has achieved all their physical therapy goals and is happy to promote their success to their doctors, friends, and family. We’re not looking for people who just get better. We want people who get better and are so excited about it that they’re going to promote it. How do we go from point A to point B? We focus on the measurement of our success and the KPI. We don’t necessarily focus on how we’re going to get from there to there and also, showing them the vision. What is that vision? It starts with that leader getting clear of the purpose and product.

I do want to touch on something that you said, Nathan, that I thought was important. You mentioned that most business owners do not spend the time or the investment in developing their purpose, vision, and values. That’s so true. We see it all the time. Part of our staging process, when we coach, is that we build in those opportunities for our clients to develop their purpose and values.

What I found is that depending on what stage you are in, the purpose and values start to weigh more. Let’s say you’ve been open for six months and you’re trying to figure out how to get patients in the door. You might have a little bit of that purpose and values but you got to get some patience in the door. It’s only you.

The purpose and values live in you.

If you don’t know what they are, they’re in your head somewhere. You got to sit down and write them down. You then hire a person and then another person. You then get a team. You want to start implementing policy, procedure, and structure. We learn all of the steps to get there and then there’s a block or we start experiencing turnover. We also get burned out and overwhelmed. We can’t figure out what to do next. Guess what we do? We start over.

It’s not about doing something else. It’s about doing what we’re doing better and doubling down on our purpose and values. That’s where we try to take that owner, pull them out of the business, and get clear on what we were trying to build so we can implement that across the organization. That’s the only path to freedom. That leads to employees that stay and refer their therapy friends to your place. Marketing and relationships in the community don’t become an issue. You figure out how to scale your practice. Your family life gets better. Everything gets better when the leader gets better.

You figure out how to scale your practice, your family life gets better, and everything gets better when the leader gets better.
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Jim, as you’ve gotten clear on your purpose and values, did you do that early on? It sounds like maybe you were already a believer in that. At what stage in your business ownership journey do you see the weight of knowing and iterating your purpose and values?

I’ve been a business owner in multiple iterations from owning a previous company with a partner to owning something solely myself. It’s a relative change for me. One of my biggest challenges, which a lot of people identify, was getting out of the day-to-day more and more to be able to have that time to truly have clarity. It’s always in there of what you want to do but having the time and the skill to be able to properly express that is a whole different ballgame.

A few years ago, I had that realization that what I’m doing at that point was not sustainable. We were successful but not to the point where we were satisfied with where we wanted to go. Frankly, I was at a point too where I still loved all my staff and enjoyed my work but it wasn’t something that I liked going. My staff could tell that and all that. I recognized there needed to be a change and that came with I needed to back away from day-to-day and all that stuff, to be able to have that open space to be able to think about these things and get clear. What I realized with that was there wasn’t a lot of clarity with all of our staff too of, “Where are we going? What are the expectations,” and all that.

Once we nailed those things down, that frees up so many things. I love going to the clinic. I still see a little bit of patients because I like to do it. I just don’t have to. I love being there and getting to interact with all of our staff, talk with them, see them winning all the time, and love what they’re doing. I realized that part of that comes from me being very clear on where we’re going and what we want to be able to do. I want them involved in those conversations too so it’s not only me dictating the vision of everything but also, they can see my passion for what we’re doing.

I get up on a soapbox almost every single day about all kinds of different things. That’s what we create. Why? It’s because I want them to push things and not be satisfied with the status quo. My view of that is that I need to be the one setting the example with that. Once I was able to get to that point where I had the clarity of what I wanted, then that gets to be extrapolated out to every single member of our organization. It frees them up to be able to do that to where it becomes like, “Let’s go pursue this. Let’s do this and this.” It’s fun to do and fulfilling. You can see a big change culture-wise too and a lot more enjoyment and fulfillment with everybody.

Did you have an external source or coach that helped you get clear on your purpose, vision, and values? Was that something you were able to come up with by yourself? I didn’t know the difference between the terms. I needed someone to hammer me down and tell me, “That’s not a purpose. That’s more of a vision.” Unfortunately, for most of the clients that we work with, their purpose is going to be something along the lines of being the best manual therapist in the community that has the greatest reputation and provides the best result. It’s something weak. Did you need some kind of help to get clear on those?

Reading several books and going through some different resources helped me to clarify that. It was always in there. I had a little hard time more with expressing those things. I didn’t particularly have specific coaching on, “This is where you want to go for the difference between those,” and all that. It took me a while to arrive at how to properly express those things in a manner that made sense to me and that I could relate to all of our staff and anyone that I talked to.

That’s how I was. I needed that external person to tell me, “You’re going down the right path. Let’s get deeper into that and ask some more questions.” That’s what I needed and I recognize that. As I did that, we were able to truncate it down into a phrase. After going through that process, I had a story behind it.

For example, we had Rise Rehabilitation Specialist. It was the clinic that we sold years ago. We came up with not only the name but also our purpose, which is, “To help others rise above.” We had a full-blown story about what that meant to us as our purpose. It had nothing to do with being the best manual therapist in the community and creating great results. It was anonymous as to what profession we were in.

However, it was inspiring. We could help others rise above. We could help team members, patients, referring providers, and vendors rise above, you name it. That permeated through the company. Share your experience a little bit, Adam. I want to know what helped you come get some clarity on purpose and values. How long do you feel like it took to get clear on those and then it permeate through the company such that you could see that the churn rate had slowed down? People were anxious to come to work and create greater KPI productivity.

I feel like we all have this story of either somebody’s going to tell you or you have a coach, “You need to stop what you’re doing. Pull out a piece of paper and write down what’s on your heart.”

You’re unproductive.

It’s like, “I would rather chew on rocks than the freaking dude. I need to get some more patience in this door. I got to go play golf.” That’s such a waste of time. For everybody who’s reading, that’s normal. You’re not weird but I always advise clients, “Trust me on this. I’m asking you to appease me.” What will happen is, it won’t be a clear story but it’ll be like we’re opening up the crack and you can see. It’ll feel weird. 6 months or 1 year will go by. You’ll come back and open it back up. You’ll then realize, “Things have changed. I don’t think like this anymore. I think like XYZ. I have people on my team. Let me dive a little deeper.”

What I’m trying to say is it’s never finished. Your purpose and values continue to evolve as the leader evolves but the thing that helped me with the turning point, got me over, and made our company bulletproof was when my team helped me rebuild it. It starts with the owner sitting in their room and writing it down on paper. One day, I had my leaders around me and I said, “I want to rebuild this company with you. It’s not about me anymore. It’s about us. I want to build something special with you, guys. Let’s put some stuff on the board.”

Whenever I did that and I let them build it, things took off. That’s when we became a family. We could argue or fight but we still loved each other. We were still coming back, solving hard problems, and kicking some butt. I have people on my team underneath me who can have that type of experience with those underneath them. It takes work and a lot of reflection. It’s going to take a couple of years to get crystal clear with your team.

You also showed based on that example that your purpose and values change over time and that’s evident in our personal lives. My purpose and values as a single man in college were different than my purpose and values when I got married. My purpose and values after I had children were much different than when I was married or it was just me and my wife. Your purpose and values change over time and they need to fit the greater influence that you have around you.

As your team expands, you can see that purpose and values need to expand or change or modify with it. I love the fact that you brought in your team. Part of the exercise I do in my annual strategic planning sessions is, “Do the purpose and values still fit for where we’re at?” Let’s be open and available to the possibility that things might need to change because our situation has changed.

I love the fact that you incorporated your team in that. It’s obvious that because you did that, the turnover rate has decreased over time. People love where they’re working. They’re producing great things. Is it okay if we move off of purpose and values but still focus on culture? We’ve worked on that particular topic.

You have your purpose and values clear, Jim. What are some of the concrete activities or exercises? How do you keep it alive? Very easily, you can generate a purpose and values. They’ll maybe be put in a notebook somewhere and collect dust for the next six months until you open it up again. If your wife’s crafty, she’ll do some stencil work on the wall to post them. How do you get that lived into the company to improve the employee experience?

We do it with a multifaceted approach. As part of our onboarding system, I made videos about all that. We updated all our values and all that stuff to better fit where we are and where we’re going, which is interesting that you are talking about that. Those things are pervasive in every conversation that we have, both in a one-on-one setting with any of our staff and then when we have our staff meetings too.

We’re always looking at what we’re doing through the lens of our core values as a company. My goal with that is I always want those to be top of mind because we are all very passionate about those. We’ve got six of them and those are all things that can be directly related to how we interact with each other and the company. Also, how we interact with our patients, how we market ourselves, and how we interact with the general community and all those things.

Those are things that we try to lean into and make part of our day-to-day life, whether it’s at work or home because those are things that we’re passionate about. We make it always there and it’s not just something. One of the statements I have in our onboarding thing is, “These are not just things that we have written down in the employee handbook and we might look at them once a year. These are things that we live by every day.” That’s my expectation of anybody that’s coming into our company. They truly believe in these things and this is the way that we want to approach things.

We did the same thing. I love what you’re talking about, Jim. You’re preaching to the choir. In our organization and even in my meetings with Adam, we will review our purpose. We’ll make sure it’s clear to both of us. We’ll talk about the values and then we’ll spend a minute talking about one of them. That was no different than part of our agenda for our leadership meetings and our teams/staff meetings. We were going to talk about purpose and values. We’re going to spend about five minutes talking about it before we start anything else.

Even in our team meetings, the clinic director was expected to assign a team member to talk about a value prior to the team meeting so they come prepared with a little five-minute talk about a value and how it was seen in the clinic at some period over the last month or two. Maybe a team member exemplified it or something like that. We were going to spend their first five minutes talking about our purpose and values on a weekly basis.

We also had value-based hiring and firing. We would talk about our values in the interview process and why they’re important to us. We ask the applicants about each value and why it might be important to them, if not. We’d also fire according to the values. It’s like, “You violated this value. You’re either being disciplined or we have to let you go because we cannot go against our core values.” It sounds like you were doing a lot of the same, Jim.

I like that, especially with the hiring part of it. The first conversation that I have with the potential staff member coming on, I am going all out about, “This is what our vision, purpose, and values are.” I lean into that kind of stuff and try to scare them off to the point of I’m going to lay it out there and be very clear about where we’re going, what we’re doing, what we’re passionate about, and what the expectations are.

Lay it out there and be very clear about where we're going, doing, what we're passionate about, and what the expectations are to find the best fit.
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If that excites you, awesome but if it doesn’t, then maybe it’s not the best fit. I go ahead and lay it all out there from the start because that’s going to help them. If they want to join us, then awesome. We set the tone for it but if not, then that’s going to help them find somewhere else that might be a better fit too.

What a great filter. I’m not trying to one-up you, I promise but we posted that stuff in the ad. “Here’s our vision, mission, and values. If you can agree to these values, then go ahead and send a resume.” We no longer do the standard job description on the ad. Forget all that stuff. We want to find the 1 out of 10 that is perfect for us and not the 20 applicants that are looking just to be a PTA.

We want to find the right person. We put that in the ads and that would follow through in the interview process. I love that you made videos about each value. What a smart move. That would’ve saved a lot of time on my end. Speaking about values, Adam, is there anything that you guys are doing to make sure your values and purpose are lived through the organization?

We’re doing a lot of the same things. We’re putting in our ads and our employee review process. On our monthly and quarterly reviews, we revisit them every year. One of the first things I do with clients is once we get to a place where we feel good about it, it’s like, “You’re going to go to the print shop, get a 5×4, and stick it on the wall. It’s going to be the biggest thing in your clinic. I want you, your patients, and everybody to see it.” That’s probably the easiest thing to do.

What we’re all talking about is developing habits or systems that help maximize exposure to your values. I wrote down a little bit of a system myself. Essentially, the leader gets better. The leader elevates. The leader creates the culture and the culture creates the process. Once the process is built, that creates the people and the people create the outcome. When you can follow that path, it’s the ultimate work of the owner to build the company.

Imagine this company is like this newborn and you’re trying to shape it and create its personality. What does it believe in? What does it stand for? That is the work of the owner. The degree to which you can do that is the degree to which you’re going to be successful. Also, it’s not Facebook ads. It’s not your problem.

The degree to which you can do that is the degree to which you will be successful.
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Getting more new patients is not your issue.

Google Reviews will not solve your problem.

That reminds me of a client. She had an amazing culture. She said, “The vibe when you walk in was up tone. Everyone’s talking, screaming, excited, and so on. I don’t know what’s happening.” I said, “If you’re in this situation, kudos to you. Ask your team and patients. Why do they like coming here? What are you providing that makes them so excited to come to work or come back for a painful therapeutic session that they know is coming up? What is it?”

She did the surveys and she recognized that about every quarter, they’re doing a team activity. It’s usually around a charity, like a 5K run, some Bowling for Dollars, or something like that. They do a food drive for a particular charity in town. To your point, Adam, that becomes a process. It’s something that they were already doing. They started paying more attention to it. That culture is not solely dependent upon the owner to be present and push the culture all the time.

When you come up with the policies and procedures, the SOPs that you’re talking about, Adam, the team knows what drives culture. When you say, “Who’s going to lead out on this 5K run this year,” people are like, “They know it’s coming up. Can I?” They’re bringing ideas to the table like, “For this quarter, can we do this? We need to come up with a quarterly thing.” To move it off of the owner and into the team that holds the culture is a huge move. That’s when it starts driving itself. Am I wrong? Are you experiencing some of this, Jim?

You nailed it. We love what we do. We’re passionate about it and all that stuff but it can’t all depend on us too. That’s just a recipe for us not being in a good position. I love having more involvement of staff. Adam, I remember you talking a while back about recognizing certain qualities and staff members and being able to lean into those things. You see that they’re good at a certain aspect of like, “Let’s see if they’re willing to take on a little bit more responsibility with this or move into that thing because they’re passionate about it.” Being able to recognize those things and getting more involvement is a crucial thing.

It all comes back to getting clear. We’ve all had the experience of coming into an important conversation and we’re not quite clear. We’re fumbling over our words and we’re like, “I need to go back and think about this for a second.” Far too often, that’s the state that owners are in all day. They’re not quite sure what they want. They haven’t gotten clear on how to communicate it. It’s frustrating and confusing.

The team is confused and problems are everywhere. Sometimes the solution to that is not doing more. It’s doing a little bit less. Go somewhere quiet, sit with yourself, and get clear on what you want so that you can communicate your values and vision. People are like, “I understand you. I’m aligned with that. I’m going to make you proud.” They’re going to go crush it for you.

Have you guys experienced this? I’m pretty sure you have, Adam, and maybe you too, Jim. When I’m starting to feel burned out or lack fulfillment, it is probably because I’m not clear on what my purpose is at that time. This is what I’m thinking. This fulfilled me for a long time, treating patients and getting results. They’re happy. Also, starting this company. It’s the fulfillment of a dream. I’m sitting in the middle of this clinic that’s owned by me. This is my thing and I’m getting patients better. It’s what I studied to be my entire life. I’m at the pinnacle of my dream.

I then start getting burned out. With clinic owners, that purpose has shifted and the ownership that they dreamed of no longer fulfills them without them knowing it. I don’t know if I’m saying that right. For me, they subconsciously know they should be doing something else while they’re still thinking they’re fulfilling their dream and treating patients because the business demands it.

There’s a different purpose than being a PT team member, which is what you are if you’re treating full-time. You’re another staff member or maybe you’re a clinic director. You own a job. However, once you become an owner and you’re not giving it the time and the energy that it needs, that strain is what leads to some of the burnout that we’re seeing. Have you guys felt that before?

I think a lot of it too. We have to change and evolve as we go through that process. It is human nature to resist change. We start to feel those different pulls. I agree with you, Nathan. You don’t know why you don’t feel that fulfillment anymore because you’re thinking, “Once I get to this point, that’s going to be it.” You get there and it’s like, “Why is this not awesome all the time and all that stuff?”

Having some of that away time and less being involved in the day-to-day is crucial for being able to be introspective and think about, “Who am I at this point? What are the things that I need to continue my fulfillment and enjoyment with progression?” It’s not for me. I would always get a lot of fulfillment out of helping people, patients, and all that stuff.

I noticed over the course of my career that I’ve started to get a lot more enjoyment out of coaching our staff and helping them with clinical and leadership development. I get the most enjoyment of getting to sit back and watch our staff work. Also, to see them enjoying themselves. I see that growth when we hire a new grad and have them grow so much over the first two years.

Also, seeing our staff that are in leadership positions thrive in those things. I get something fulfillment out of knowing that I’m a part of that and being able to help facilitate that. That’s a big change from years ago. It was all about, “I need to be the man. I’m going to be the best PT,” and all that stuff. Also, realizing, “That can only take me so far.”

Owners don’t ask that question. They’re in the beginning or burnout stage and are like, “What would make me happy and more fulfilled?” I don’t think they ask that question. I had a client like that. I was like, “What do you want?” He’s like, “I don’t know.” Either he doesn’t know or he’s embarrassed to say, “I want more,” because that’s gluttonous. You can’t be so selfish that you want more for yourself. Get clear about it. Maybe they’re also avoiding it because once they do get clear about it, they know the actions to take and what to do. Maybe it’s easier to suffer in ignorance.

I love what Jim said about coaching his team. That’s awesome. Another turning point that I had in my business was when I realized I no longer had a physical therapy company. I had a coaching company. I was coaching my team on how to run a physical therapist company. Whenever that shift changed for me, I got out of the way. I felt like that was awesome.

Another point that Nathan made was owners find themselves out of touch with their purpose. It feels a lot like overwhelm, burnout, and uncomfortable feelings. Whenever we can get to a place where you’re busy but having a blast, that is whenever you know you’re in alignment. You can get your team together and say, “I’m so busy. Does anybody here feel overwhelmed?” If you start seeing, “I’m burned out. I’m overwhelmed.” “Let’s do some cultured work. We got to do some vision work.” It’s rally time. I want to feel busy, almost like I can’t keep up but I’m having a lot of fun. That’s where the sweet spot is.

I’m glad you said that too because we had that conversation about some things clinical-wise and having some realizations. We took a step back and look at where we are from a patient diversity standpoint and stuff like that. Also, seeing where some of our staff are starting to experience some overwhelm and things like that. Being able to identify the reasons for that and have them be a part of, “This is where we’re going and what we’re going to do to address those things,” is a very powerful thing.

As much as we talk about that we want a culture to be awesome all the time and all that stuff, I don’t think that’s a realistic thing for everybody to be happy all the time with things too. The greater part of that is whenever there are some things that maybe something bad happens or we start to see a trend of something like that, it’s more about what our reaction is to it. How are we going to address it in a constructive manner but also in a manner where it’s not only me saying, “We’re going to do this because this is happening.” It’s more of, “How’s everybody feel about this? What are your ideas of what we can do to help these things and be able to help guide those conversations and that thought process?”

We do come up against issues. Even though we have a running culture that is pretty good, we’re going to have bumps in the road. There are two things that come to mind when we had those times. One was our motto, which we also stated every time before every meeting was, “Production is the basis of morale.” Is production going down? If so, maybe we can address that. We can talk about how to be more productive.

If it’s simply a number of new patients are down, how can we generate more new patients to get production back up? That’s number one. Sometimes you see morale tied to production and you might even see some of the least productive people on your team have the most complaints about burnout and being too busy, which is odd but we would see that in general.

The second thing is, what values are we not living up to? Are we going against some of our values and our policies and procedures, or how we handle things, or how a leader handled a thing that might have disrupted the culture in some way? We have to be willing to be introspective. Maybe we’re saying we want these values but we’re not living accordingly. Those are two things that come to mind. What comes to your mind, Adam, when you do have bumps in culture?

Be willing to be introspective about living up to the values accordingly.
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I’m not a psychologist but there’s a lot of psychology in that question. I can tell you that it feels weird. That’s usually where I recognize it.

It’s the atmosphere.

It’s not something I could put words to but it’s like, “Something’s not quite right here.”

Sometimes it starts with a person. We’ve had poisonous people that we had to ferret out because they’ll start spreading rumors and gossip. We have to start talking amongst the team and be clear. Also, understand that if some of that’s happening, other team members need to raise their hand and say, “This is wrong, what’s happening over here.” Either to them, their faces, or their supervisor.

It’s going to look like we’re not having fun and it feels like we don’t trust each other. We’re not being honest with each other and it makes me feel almost like people are in their little world and they’re protective. It’s a great opportunity for the owner to step in and say, “Team, I could be off. It’s probably just me but I feel like something’s off here. Let’s open the door and talk. What’s going on?” Be quiet, sit there, and wait. If you don’t solve that problem, it will come out. You’re going to hear, “I’ve been having.” “Tell me more about that. Let’s go.” You’re digging.

Have you had this happen, Adam?

Sure. “Team, this is the most important thing in my life other than my family. We can sit here all day until we get to the bottom of this.”

“Call off the patients. This is going against your paid time off. Let’s go.”

“The next hour is lunch. Let’s keep rolling with it.” It’s like, “That’s how much I care about this business and this company. I’m willing to do whatever it takes. How can I help? Are you with me or not?” That’s the owner’s work. That’s what it takes.

Ben Larsen said the same thing. He said, “Ninety percent of the time, it starts with a person.” I agree with that to a point. Usually, there’s an upset with somebody that either they got offended maybe because it goes back to, “We didn’t live up to our values as we said we were going to,” or their production is down so their morale is low. I can see that 90% of the time it starts with a person. Thanks, Ben.

If you have a decent hiring process and you’re clear on your vision and values, then that becomes less of a thing. What I found is that my mindset shifted over time from, “Something is wrong with that person,” to, “What does that person need from me?” I started asking myself that question and realizing that we’re all on a journey to getting better. “I’ve been a jerk. I’ve done some jerk things in my life. I’ve had to be rallied up, mentored. You’re better than that, Adam.”

Sometimes, that’s all they need from us. “I’m seeing this behavior. I know you’re a good person. I’m here to serve you. I can’t be flexible with that but as long as you’re willing to work with me, then I’m willing to serve you as long as it takes. Are you open to doing that with me?” If they say, “Yes,” I’m going to stick with you. If they say no, then it’s a person problem or more of an alignment problem.

I’ve failed at this so much over and over in my career. What I found a lot of times is I didn’t properly provide clarity for that staff member in the expectations or how we do things. Your initial knee-jerk reaction, especially when you’re not thinking about the overall impact of things is like, “Why is this person not doing that?” It then gets bad. However, when you think about it, it’s like, “Did I properly show them how to do this or give them clarity in how we do that?”

If the answer is yes, that can lead to one conversation but the vast majority of the time, we didn’t provide clarity on those things. When somebody has that uncertainty, all that’s doing is robbing them of their comfort and happiness with things too. If we do have a staff member that’s not performing as well as we would like or doing something that’s against some of our values or expectations of performance, we need to first look, “As a management team, did we give them the tools and the clarity of what’s expected in this to make sure that’s not the issue first?” That’s a tough thing too because the ego for us is, “They should be doing this stuff,” and all that but having an introspection to like, “Have I done my job well enough to allow them to be able to do their job?”

When somebody has uncertainty, it robs them of their comfort and happiness with things.
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I agree. We would have that conversation all the time. The other thing I found out over time from my experience is when someone starts acting out, greater than 50% of the time, something wrong is happening at home or in their personal life. You’d like to think you could keep personal from work. I’d like to know how to do that because I don’t think it’s possible. I see that something happened in their personal life that is showing up in how they’re acting at work.

I love what you’re talking about, Adam. It’s giving them that space like, “Something is off. I don’t know what’s happened. Maybe someone said something to you here or you didn’t like how someone acted but is there anything I need to know so I can help because you’re not the same person,” or however you want to phrase it? Also, I’ve noticed in those situations that maybe there are issues with a child, finances, or marriage, you name it. Something’s going down and it bleeds over into work. You have to be open to that. It’s not always like they don’t know what they’re doing.

It’s rarely that in my experience. Don’t get me wrong. There are times when people aren’t aligned with you. I’ve had those hard conversations.

I see that most of the time. When we implement core values, the people who don’t agree with those values stick up and they get out of your clinic within the first six months but after it’s been a while, it’s what you’re talking about.

“Employee, I can understand and I empathize with you. I see how this transition would be difficult. I get it but I want you to know that I’m here to support you. I’m here to rally you and the team together to do whatever I can to help you get there.” Here’s the golden question, “Are you willing to do that with me?” They have to say yes.

As long as they say yes, that is an aligned person, unless there are some performance issues outside of culture. I’ve always told people that it’s not about getting it right. It’s about learning. As long as we’re all here willing to learn, we’re going to get there. I’ve never heard of anybody in my life who put in the work, tried, and gave it their all but didn’t succeed. That’s never happened.

It's not about getting it right. It's about learning. And if as long as we're all here willing to learn, we will get there.
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As long as I know you’re giving it your all and you’re willing to do that with me, then we can work together. To be quite honest, that is the level of service that owners have to give their employees. People are not going to stick around for a paycheck anymore. You have to be that mentor and that person for your team.

I love that you bring it down to a yes and no question. It is the time to plant the flag and testify to your commitment to the team essentially. This is the moment.

If you don’t want to, it’s no big deal. “How else can I help you? I’ve got some people. This guy is named Jim. He’ll hire you. I’m here to help you.”

Having some of those honest conversations were helpful because there was one guy that was productive and he didn’t like our systems. That didn’t come out until months and months of conversations. His productivity wouldn’t come up. He would always kick back. He would complain. We finally got down to, “What is it?” He’d say, “I don’t like how you guys do these things and your belief systems around them.”

We’re like, “Thank you for finally telling us. Can we give you a letter of recommendation? We will find your next place of employment. Give us time to find that next person, if you don’t mind.” He is like, “You’d do that for me?” I’m like, “Yeah. We have a lot of connections that could get closer to home and in an atmosphere that you’d appreciate better than ours. Will you work together with us on that?” He’s like, “Yes.”

All of a sudden, his attitude was different. His productivity went up. We found him his next job. We got him interviews set up with our friends. You got to be open to that possibility and that it’s okay. You’d rather have someone be honest and help them out the door in a good manner than keep someone on there who hates your atmosphere. They’re going to sit there, wallow, and complain because they don’t know that there are options.

As we’re coming to the end, that’s a super great theme of the whole episode here. It’s getting the owner to find a routine that allows him to be in that head space more often so they can lead their team in that fashion. It’s such a hard thing for the owner to be that leader that they need to be when they’re seeing 50, 60, or 70 patients a week. It’s overwhelming, stressful, grinding, and having problems. If you are that person who’s got the overwhelm, who’s been treating full-time for years and having a hard time getting stuck, please ask questions. DM me, Jim, or Nathan. We are happy to help you or point you in the right direction.

You can email us at Nathan@PTOClub.com or Adam@PTOClub.com . Jim, if they wanted to reach out to you, where do they find you?

The easiest email is FloydDPT@Gmail.com. My company is Ascent Total Performance in Columbia, South Carolina. Our website is AchieveATP.com. I’m happy to help with anything. If you know anyone who’s looking for a job and is passionate about what we do, we’re always happy to chat with that as well.

It’s a great little round table here. This was awesome.

I loved it. I had fun. Let’s do it again.

It’s always fun to talk about these things. We have to have Jim on again. It was good to meet you. I’ll be happy to have you on the show as well. We look forward to it. Thanks, Adam. I appreciate it, guys.

Thanks, Nathan and Jim. I’ll talk to you next time.

Since graduation, Adam has been committed and driven to make a positive impact in the world of physical rehabilitation. Adam, with the help and guidance of mentors, founded Southern Physical Therapy Clinic, Inc. in 2019 and has since developed a passion for leadership.

He continues to work closely with business consultants to continue to grow Southern to be everything that it can. 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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The post Creating Amazing Culture That Fulfills Owners, Engages Teams, & Drives Itself With Adam Robin, Jim Floyd, And Nathan Shields – PT Owners Club FB Live Event appeared first on Physical Therapy Owners Club.