The Answer To Feeling “Stuck” Or Lack Of Focus – A PT Owners Club Facebook Live Event With Steve Thompson, Adam Robin, And Nathan Shields

Consistently toiling without a vision can cause a PT owner to feel “stuck,” unfulfilled, and even agitated. In this episode of the Physical Therapy Owners Club podcast, we invite you to join our enlightening Facebook Live event featuring Steve Thompson, Adam Robin, and Nathan Shields. Together, they discuss the transformative power of a well-defined vision, exploring how it can revolutionize not only your own journey but also the dynamics within your team. No more uncertainty or wasted effort because having a vision makes all the hard work productive and meaningful. With a shared vision, your team can align their efforts and collectively move towards your desired destination. Tune in now and discover the profound impact of having a vision in your PT practice.

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We’ve got a special guest, Steve Thompson , joining me and Adam. Steve, thanks for joining us.

It is great to be here. Thanks for inviting me on.

Steve, what is the biggest stumbling block you find with most PT owners as you start working with them and coaching them?

It’s one that needs to be clarified. Most owners don’t have a vision. They don’t have clarity about where they want to go. Let’s say you’re going to take a trip. If you don’t know where you’re going, you’re going to spin in circles.

We talked about this a little bit before. People approach us to get answers in terms of, “Where to find new patients? Where do I find physical therapists in this day and age? How do I improve my front office collections or my billion collections? What EMR program should I use?” A lot of that matters, but what usually stumps them is when we come back and say, “Where do you want to go with this? What’s your vision?” “I want to have some clinics, and I want to do this.”

Why? What’s your greater vision for this? What do you envision for your life? What would be your ideal scene? That makes people pause. It’s odd that they haven’t taken the time. I’m not being judgmental because I’m in that space, and I find myself in that space many times. It’s odd that they don’t have that clarity of vision to work from.

Very true. They may have had a vision early on because they wanted to start a practice. They want to open up a practice. Vision number one, create it. Now, I’m here. I’m in my vision, now what? A vision can be continually changed, modified, added to, reduced, and updated. That’s probably where I see most of the people get stuck. They make gains in their business, but then they level out, and they don’t know what to do.

A PT has said, “I want to open up my practice,” and they do it. All of a sudden, years later, they’re surrounded by staff and patients. They’re like, “How did I get here? What am I doing now? I want my staff to work together. I want to have more new patients,” as you said. If you don’t know where you’re going, you’re going to spin in circles and be frustrated.

Adam, as you’re growing your practice, have you felt a lack of clarity in regard to your vision has limited you? In other words, do you find that it’s been easier to progress once you’ve had clarity of vision?

It gets more exciting. That’s what I feel. I’m a feeler. I usually like to feel things when things are off. Lack of vision, to me, feels very unappealing, boring, and mundane. I almost feel a sense of agitation with my situation and my surroundings. I’m not happy, maybe a little grumpy. It’s like this spark. I’m sure we’ve all had it like when we get on a coaching call, and somebody can help you get clear on what you want. They have that little window of clarity, and you get this refreshing, new, and exciting sense of direction. That’s how I experience whenever vision starts to reveal itself. The superpower after that is helping your team get aligned with that. It is helping your team understand what you’re seeing, feeling, and what you’re excited about. That’s a tier two of how to use vision.

Steve, what do you find keeps people from gaining that clarity or updating the vision? What keeps them from getting that?

Life in their practice. They get busy. There are a couple of other barriers. There’s limited thinking and limited beliefs that they might have, like, “I can’t grow this.” They’ve become the jack of all trades where they have to do everything. “I’m the only one who can do it,” and they box themselves in, not thinking that, “I have to be the one who cleans the bathrooms.” They basically make themselves irreplaceable.

They don’t create themselves space to be able to sit down and create a vision. One thing I loved you said is that a vision creates alignment in the business. Not only in the directions that you’re going and the decisions that you’re making, but it’s going to create alignment with your staff. It’s also going to build your culture and create teamwork.

A vision creates alignment.
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Those are other things that you always hear clients or owners want. It’s like, “I want my team to work for me. I want everybody to get on the same page. I want a better culture.” If you don’t have a vision, what are we following? Create that vision and share it. That’s another thing, too. Sometimes, owners have a vision, but they just haven’t shared it. They have an idea, but maybe there’s a restriction in themselves, like, “I don’t want to tell him that I don’t want to grow to five clinics,” because that will “sound greedy.” There are those limiting beliefs like, “I have big dreams, but I don’t want to share them because someone might pick them apart.”

There’s a lot of that that’s part of it as well. I like that you use the word greedy. The word that comes to mind also is a fear that they’ll look like they’re being selfish. You’ve experienced this plenty of times. I experienced it personally and Adam as well, especially for those owners who are still working and treating patients quite a bit in their practice. If their ideal scene is to not be treated as much and they pull out of treatment, either to part-time or seeing no patients at all and anywhere in between, them not seeing patients is going to be looked at like, “What are you doing with your time?” They’re going to be judged by their team, even though that might be their vision.

This might be an updated version of their vision, or they might recognize in order to achieve a certain vision, “I’m going to have to sacrifice patient care, and in doing so, that might make me look bad to my team.” Immediately, they squash their visions instead of thinking about what the possibilities might be or, “How can I overcome that hurdle to achieve my vision?” I see that their go-to and reflexive action is to keep doing the status quo. Adam brought it up. That’s when they feel stuck.

They feel stuck because they’ve limited their vision because they’re unwilling to open up the possibilities that it is possible to have this expanded vision where you’re not treating and your team is not going to be upset about it. They have to get over it. That’s where a lot of coaching, therapy, or counseling is, whatever it takes to get over that psychological roadblock happens. I’m sure you experienced it. Adam, you experience it as well.

What if that wasn’t true? What if that’s all just a story you’re telling yourself? None of that’s true. A good question that I like to ask is, “What do you want?” As owners, we were self-sacrificing when we were running our business. We gave ourselves to our patients. We give all of our time, money, and energy away. Sometimes, they solve all their problems by giving themselves to the problem, and that depletes them.

I hear you identifying all these problems, which is great, but what do you want to happen? What would be the ideal scene? For whatever reason, that question helps me switch out of that negative mindset of problems, solving problems, and limitations, there’s a ceiling, everybody’s-out-to-get-me type of mentality, then I step into more possibility and dream, “What if I could triple the size of this clinic? What if I could open five locations?” I feel like if we can get owners into that mindset more often, then things typically move a lot better.

What questions do you ask owners to inspire that vision or help them create that vision?

For me, I always ask, “What do you want?” I always like to say something like, “Here’s an idea. What if you just let the person you hired to do it?” Something like that, then you hear a light bulb go off. What possibility would that give you? If you were able to get rid of that, what opportunities with that allow you to have? That gets them down that road of what’s possible. Those are some of the questions. What about you, Steve?

A couple of things you said in there hit something. One is, I don’t know if owners never necessarily give themselves permission to dream or to even put it out there, like, “Maybe I don’t want to treat,” but yet they don’t feel like they have permission to step away. They think their staff is going to tell them, “What are you doing? You’re sitting at home.” I like the what-if part in the question of what you want.

I owned a practice for several years. I’ve been a PT for many years. The toughest question for me to answer was what I want. As Adam said, we give so much that we’re so focused on what everybody else wants, especially now in the days of staff turnover and the work-life balance issues that people are talking about. We’re trying to put everybody ahead of ourselves. That’s a nice thing about a vision. It’s probably one of the first times you get to say, “This is what I want.” Some things that I like to do with clients is take them on a time capsule journey and say, “Let’s look ahead six months from now.”

Let’s say January 1st, we’re on a call. What’s happened? What do you want to be on January 1? Take them a year in advance and say, “We’re now talking a year. What’s happened in the past year that when you look back, you’re so happy about?” Either personally or professionally, you’re now in a different place. Take them into the future and let them play, turn it around, and define what’s changed and different. If you have a tough time answering the question, “What do you want?” take them in a time machine and say, “What does it look like now?” and dream. You capture some vision ideas there.

That’s a hard question to answer for some people. I know I’ve had issues with that in the past, especially after selling my PT clinics, like, “What do I want now?” I don’t know. That hesitation comes up, “I want to make more money. I want to do more things.” That’s when the negative voice inside my head starts telling me, “You can’t do that. That’s asking too much. You shouldn’t bother that. You’re being greedy. Wanting to make $1 million a year is crazy.” What you find out as you present that vision to a coach, friends, and other people, more often than not, they’re supportive and excited. They want to do more with you and want to help you. As you share that, other opportunities come across your path is what I’ve noticed.

As business owners, we want to grow. We want our practice to grow and do new programs, and so does everybody else in our practice. We’re doing the same things over and over. Does that relate to some of our staff turnover that we’re not giving people the opportunity to grow or we’re not giving people the opportunity to help us? We get that fierce warrior, “I got to do this all myself,” and you wonder why your staff keeps turning over because you’ve never let them help and grow.

Most of the time, they’re going off and opening up their own practice or going on to be a clinic director somewhere. You brought up a great point. When you sold your practice, it’s that identity shift. Another major thing for some owners is, “I have to step into being an owner. What does that look like? I’m not sure. I’m going to go back and treat.” They revert back to what they know. I always love to ask owners a question, “When you go to a party, how do you introduce yourself?” 9 times out of 10, they say, “I’m a physical therapist,” instead of, “I’m a PT practice owner.” It’s getting clearer in that identity of who you are. That may be a limiting belief as to why people don’t do a vision either because they never define what is an owner and what does it mean to be an owner.

To their point, they’ve never been trained to be an owner. They don’t know what running a business looks like. What do you do with your admin time? That is their role. As I like to say, once you open a clinic, you’re no longer a physical therapist. You’re a business owner who happens to have a physical therapy clinic, and you’re a PT within that, but they don’t take on that ownership mantle until later on down the road. It’s usually because they’ve been compelled in one way or another to figure out that, “That’s right, I own the business, and it all ends with me.”

That vision is obscured out of naivety, ignorance, and lack of training. “We didn’t have any training in any of this to know what it is that it looks like to be a real business owner, and I’m not treating patients, which I’ve spent the last couple of decades building my entire life up to treat patients. Now, you’re telling me I have to identity shift, capture a new persona, and train on what it’s like to be a business owner?” That can obscure the vision.

When there’s confusion, there’s paralysis. When they’re confused about what to do next, then they’re not going to do anything. That’s why it’s so important to have an outside source, whether it’s a mentor, coach, consultant, therapist, or a great spouse that can lead you down that path to say, “You’re not a therapist anymore. You’re a business owner. You probably need to clarify the vision around that.”

Also, to hold them accountable for that. You probably have heard your clients say, “I got a squeeze in these extra patients.” Are you the one who has to do it, or does your therapist have to do it? It’s holding them accountable to the path that they choose.

Also, to speak to your point, Steve, where you talked about if you are doing all the work in your clinic, all the admin, and cleaning all the sheets, what do your employees see as a path for growth? Do they see a path for growth if you are always there doing all the things? There are plenty of people on your team who would probably love to take on some leadership responsibilities and grow professionally, but you could be the limiting factor. For all the things that you’re trying to do on behalf of them, you could be the stumbling block that keeps them from progressing in their life.

You have to recognize that your job is to build the foundation for them in which to grow and get out of their way, and train, teach, and coach your team members. As you work up the organizational chart, bring them along with you. You tell me if I’m wrong, Adam. When you move up that organizational chart and you see your team members grow up in leadership with you, there’s a different sense of fulfillment that comes from your company and the ownership seat.

That’s when it gets super fun. My question for Steve is this. We talk about owners and defining what their vision is. Sometimes, the first question is, “If I let somebody else do that, then what am I going to do?” There’s a disconnect there. Speaking to Nathan’s question, I see that in my employees, too. If I don’t answer the phones anymore, what am I going to do with my time? I also see it a lot more prevalent in owners who’ve figured it out, who are like eclipsed in that $1 million-a-year mark and thinking about going to three clinics.

You have to first establish what you are doing on that onboard first. If you can get clear on what you’re doing, then it helps me understand the things that I can delegate. Sometimes, that’s a disconnect where people don’t know what action to take toward their vision if they have one because they haven’t envisioned themselves sitting in that role yet.

A lot of times, they hold on to things because no one else would want to do it. “That’s a low job, so I’ll just keep doing it. I’ll keep doing the laundry,” or whatever it is that they’re doing. Adam, to your point, to go to three clinics, what would you have to do to be able to manage that? Where do you show your greatest value to your company? Is it the one who does the laundry, or is it the person who’s out there marketing and making the connections to the doctors?

How do you show up best for the practice? It may start with what things don’t you like to do in your day. Start there. Delegate off the stuff you don’t like to do, then delegate the stuff that you could have a tech or a $15 or $20 an hour person do. Stay at your highest level because, as a practice owner, you’re the visionary and the leader. You have to keep creating. We’ve all seen the rate of change and practices. Practice is almost accelerated. We have to keep revisiting the vision and revisiting the direction that we’re going because something may come up and ensure we may change policies.

We have to be able to have the freedom to step back and be able to look like, “I see this coming. We need to steer in this direction. We need to go and create a program to help offset this.” If you’re thick into the treatment, you won’t be able to do it. Years down the road, you’ll be like, “Why is my revenue down?” We need to have our eyes on it. You need to have your dashboard and see what’s going on in the practice.

I love what you said about doing that simple exercise of what brings you energy, what doesn’t bring you energy, and what you can do to offload all of those other things that don’t bring you energy. As you or anyone reading goes through that exercise, your vision seems to become clearer by doing that. If you don’t have a clear idea of what your vision looks like, maybe going through that exercise could create that vision for you in terms of your responsibilities and what your ideal day might look like. If you love marketing, you need to offload all your other stuff so you can just focus on marketing and, eventually, get an assistant underneath you.

If that idea fills you with so much excitement and joy, there are some people out there who like doing that. It’s not me, but that’s a perfect example. I didn’t want to do any of the marketing, and when I found out there was someone on my team who wanted to do that stuff, I couldn’t believe that someone could want to do that stuff.

When I found that they could, that completely changed my vision, like, “Do you mean I can still run a clinic, you’re going to do the marketing, and there’s going to be this consistent marketing effort being done instead of me doing it, someone else is doing it that’s excited about it, and probably will do better at it because I’m not excited about it?” All of a sudden, my vision changed. My vision was clear as to what I wanted to do next. Now, all these other possibilities came into play. I love that you brought up that exercise because it feels like it could bring some clarity to someone who’s questioning what their vision looks like.

I love what you said because it made me think in line with what Adam was saying a little bit ago. Probably what happens in their mind is that if they say, “I want to go to three clinics. I’m already doing so many things I don’t like to do,” and we’ll multiply that by three. Now, I’m doing it three times as much. I don’t want to do that. I’m going to stay just as I am. The phrase that popped into my head when you were talking was, “One man’s garbage is another man’s gold.”

There are things that you don’t like to do, but there’s probably somebody on your staff who would love to do that, would love to organize, and keep it clean. There are some people who love to keep things tidy, clean, and organized. God bless them. Give them the chance to do that, and they’re fulfilled. Now, they’re a happy contributing member of the team. They’re waiting for you to go clean it when if it’s not something you like to do, then they’re going to start grumbling like, “This place is dirty.” Again, it comes back to permission and the ability to allow ourselves to say yes or no to what we want to do.

One of the other beauties of having a vision is it allows you to also use that as a filtering system because plenty of opportunities are going to come for physical therapists, especially in terms of cash pay opportunities and services that they’re going to provide that are outside of direct patient care. Having a clear vision allows them to say yes and no quicker, I would assume. Even though such and such might be a great opportunity, a great investment, make more money, and have wonderful ROI, does it fall in line with our vision and values?

Is this going to get us further along where we want to go? As you said, you could be bringing on cash-pay services that 1) You never considered. 2) On a clear day, you would have said no in the first place. Some of the benefits of getting clear on that is, am I open to all services? Depending on the clarity and the largeness of your vision, then you can make filtering decisions. Adam, did you ever consider beforehand that you would have pediatrics and speech on your team? Once that was presented to you, you either captured that vision and went with it, but there had to be a place where that could fit within the greater vision. I’m assuming you experienced some of that.

The clearer that I get, the clearer my team gets and the more excited my team gets.

Steve, you did mention there are times when curveballs come. Insurances do their things, or somebody quits and now you have to jump back into treatment. I had somebody send me a DM not too long ago. Somebody quit. Her vision is to step out of treatment, and now she’s having to decide, “Do I jump into treatment? Do I go against what I want long-term? What do I do here?” My question is, what is your filter? How do you answer that question? Is it okay to temporarily step out of line and go against your true North? How do you solve that problem?

It fits in with this topic of vision. If you know that you want to get to a certain place, you’ll create the conditions that you’re willing to accept. You’ll create the condition like, “I’ll step back into treatment, but it’s only for a finite period of time because I know I need to focus on the other things.” It becomes a matter of choice at that point. When you’re at choice, you feel the most control. It’s like, “Should I have to go back and treat?” versus, “I get to go back and treat. I’m going to do it for X period of time. I’m going to get somebody started on recruiting and pull somebody to help me while I’m done, but I’m going to be stepping out.”

If you know that you want to get to a certain place, you'll create the conditions that you're willing to accept.
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You tell your staff, “This is going to be temporary. This is going to be short term,” or you look at your staff and say, “Maybe they’re not 100% busy. I’m going to lean on them, and I’ll be the backstop.” If your team is united around where you want to go, they will recognize that you’re being pulled off track. They’ll say, “Let me step up and help.”

One of Tim Ferriss’s most famous TED Talks is about fear setting. To your point, Steve, maybe part B of setting up a vision is what happens if things go sideways. What happens if things go wrong? What am I going to do about it? How am I going to respond? It’s a worthwhile exercise. That is to say, “My ideal vision includes me not treating patients anymore.” One thing that’s helped me in the past, and you guys might have used it as well, is the impact filter. I love that. It’s a one-page thing. As I’m establishing it, it asks for clarity like, “What does the success of this project look like?”

You have to answer, “If this is going to be successful, these things have to happen and be in place. What are the effects if I don’t make this move?” It helped me clarify some vision in working with Adam and another physical therapist. My diagnostics business is like, “If we’re going to work together on this, this is what I need to see on my end, so we’re clear.”

That end of itself could then translate into Adam’s example. If someone quits, am I an option? Yes or no. If I am, then here are my parameters. If I’m not, what’s my plan B? What are we going to do in that situation? If you’re leaning on me to be the PRN Physical Therapist but I’m not willing to treat patients, let’s figure that out ahead of time so that we can keep that vision clean. You’re supposed to do a little bit of work. You create the vision then you work backward. You need to make sure, number one, it’s going to happen because we’re going to set goals around it. Also, what if things go sideways? We need to have some ideas of what to do.

As you said, that creates the parameters for what you’re going to make decisions. Plan A is this plan, and plan B is this one. It gets you to think ahead so you’re not surprised when something comes up, versus you don’t make a plan, and somebody quits. Now you’re scrambling and floundering. Months later, “Where am I again? What are we supposed to be doing?” I love what you said. It’s that impact filter. What’s important about this? What’s important about me staying out of treatment if that’s the choice? It also puts someone in their control. I get to choose what I want to do here instead of being dragged into something. Some people might say, “I had to go back in.” Did you?

Did you have to?

Did you choose to, or did you chose to? Either way, you’re making a choice. That’s the beauty of having that vision to be able to say, “This is where we’re going.” To your point, sometimes when they get dragged back into treatment, they get so panicked that they then hire someone with a license and a pulse. Now, you started to corrupt the culture because you were trying to rescue yourself to get out. If you have plan A, I’m going to step in for a period of time, we’re going to find somebody, and you make good choices that way, choices that support the vision. Oftentimes, it’s a mindset thing. When someone leaves, is it catastrophic or it’s a chance to upgrade?

This is to both of you, Steve and Adam. Once you have helped a PT owner client establish a vision, don’t you find that your abilities as a coach become a little bit easier? Also, don’t you find that their next steps and their 6 and 12-month goals become pretty easy to figure out? There are many times when people feel stuck. They don’t know what to work on next, but if we can get clear on the vision, then the next steps and the goals for the next 6 to 12 months start falling into place. Now we’ve got priorities, and that feeling of being stuck can fairly easily be overcome.

I was reading your mind. I was like, “You almost become irrelevant after they get that little glimpse.” I always tell everybody I work with, “I’m not the hero, you are. You have all the answers.” Vision does solve a lot of problems for you. The other thing that I noticed is vision is like your ability to see into the future. In the beginning, when we’re not very good at that, we can’t see. We’re just like day-by-day.

A vision is like your ability to see into the future.
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Once we figure it out, then we can start seeing week by week, then we start seeing month by month, then it’s quarter by quarter and year by year. Our ability to zoom further out gets greater. I’m not so sure why that happens, but it’s practice. Steve, I would love to hear your thoughts on why that happens and what’s your experience with that.

My experience with that is when someone can only see tomorrow because they’re so far down into the weeds or the muck of the practice that they can’t lift their head up to see above water, they’re problem-solving and fighting each fire. What I heard was space. You create the space to be able to see into next week or next month. What I heard and what I wanted to say was that the problem is, a lot of times, when business owners make a vision, they often make it in the clinic. They spend their time, “I’m going to go in my back office. I’m going to create my vision.” They’re in the thick of it right there. They’re only going to make a limited vision.

I encourage people to create space, get out, get away, and be able to lift their heads up and look at their practice to see what they need to do. The difference between going from day to day problem solving is that’s what it is. You’re putting out fires versus creating that long-term vision where you’re now becoming the air traffic controller. You’re now perched up on the top, looking down and directing traffic versus being in traffic.

How often do you guys find yourselves referencing either your personal visions or with your clients referencing the visions?

I like to do 30-day touch points or at least every 30 days, but it’s a little bit more in-depth every 90 days. The way that I typically do it is we’ll set an annual strategic plan. Depending on how many times you’ve done that, it gets clearer each time you do it. The first time you do it, it might be written with crayons and super off-base. Every quarter, we touch back, and we reference the annual plan. We make sure that we’re on track.

We get clear for the 90-day quarter. Every month, we get clear that we’re on track with the 90-day plan. It all starts with an annual strategic plan. My experience is that if you can get clear and spend a whole day building out that annual plan, your month-to-month isn’t so chaotic. You’re going to have minor shifts, but you get 80% of the base stable and get clear. Your team gets on the same page. The problem that we get is when we don’t get clear in that annual plan, we’re bouncing back and forth a month. Every month, we get the Shiny Object syndrome. We’re chasing this thing and that thing. We’ll do marketing, recruiting, and hiring. We’re like the dog chasing our tail, which is spinning around in circles.

As Nathan said, it’s like reverse engineering, create the vision, then what do I want to accomplish in the next 90 days that will reinforce that vision? Take a smaller chunk and ask, “What can I accomplish in three months versus a year?” Sometimes, people can’t focus for longer than a couple of months, nor can we predict what’s going to happen. A staff person might leave.

If we work in those smaller containers for 90 days, even 30 days, and even a week, how does each one of those stack up and compare to the overall vision? It helps you stay on track and prevents you from going off the off-ramp onto another highway where, all of a sudden, you’re wondering, “How did I get here?” If I want to stay on this interstate, I know I’m not going to take the wrong exit a thing.

To get into the weeds a little bit, Adam, do you find yourself revisiting division and the priorities with your leadership team on a quarterly basis or even more often and then doing that annual strategic planning as well?

Quarterly with the leadership team. Everybody has their own way of doing it. What I typically do is we pull out the board and see the departments. We have marketing, recruiting, finance, and operations. We have everything right there, then we have to ask ourselves like, “Which one of these departments is where we need to be focusing for this quarter?” Sometimes it’s multiple, but where’s the priority? It’s in marketing. Let’s zoom in on marketing. Which one of these areas of the marketing team can we break down objectives that are specific to that marketing?

If you get the org board, that’s the ship that’s going. I always like to start with the org board. Every 30 days, we submit our focus, what we call our big three. What are our big three objectives for the 30 days? We report on the big three from the previous month. Ideally, they align very directly with the priorities that we set in the quarterly meeting.

That keeps everybody in line and focused. Everybody gets excited because they’re connected to something important. We have a company that we’re running together, and it’s not just I’m treating patients all the time. I’m a part of something, and that takes work from the owner to put that together and create that environment for your team to work together as opposed to throwing them in the clinic and keeping them in the dark all the time. It’s no fun.

That speaks to your capabilities as a leader because you should be at the helm of the ship, looking forward and seeing what’s happening. On that quarterly event, you look to your leadership team and ask, “Are we headed in the right direction? Did we fall off in the last 90 days? Where are we missing the point? Did we get distracted by something else that came up because of things?”

It’s imperative that we get back and centered on a routine basis in order to move it in the right direction. In that way, then we can say, “At the end of the year, we accomplish blank.” It is the 4DX, Four Disciplines of Execution , where they talk about moving big rocks quarterly. I haven’t read the book but for reference to it. Those who are big into that, I believe will pick the “big rock,” and say, “Marketing is our issue this month. What do we need to do with marketing in order to move closer to the vision or achieve the goals that we established at the beginning of the year?” if that’s a sticking point or if that’s being an issue. Do you recommend something similar, Steve?

One of the things that I always like to share with my clients is based on building bridges and working on transitions. He’s like the guru who wrote things on transitions. He said, “As a leader, if you’re going to create a vision, you got to realize you’re creating change.” You’re creating some small little tweaks to the business. In change, people tend to get afraid of it. They want things to be the same, but change is a momentary decision and a momentary situation.

As a leader, if you're going to create a vision, you have to realize you're creating change.
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It’s the transition afterward where it gets sticky. It is the transition we have in the frequent meetings. What Bill Bridge talks about is you have to talk about the four Ps, the Purpose. Why are we doing this? What does the Picture look like? What does it look like when we get there? As a visionary and a leader, you have to paint the picture of where we’re going. Why are we changing this EMR? It’s because it’s going to look like this on this side, then what’s the Plan? You can then say, “In quarter one, we’re going to hit the marketing button here. In quarter two, we’re going to hit the finance button.”

The fourth important P is the Part. Get everybody involved. Somebody needs a job. They need responsibility. Also, it brings them all together to help with that. During this, you have to listen to people because there are some people who will freak out. They think, “Will I have a job? Am I going to change?” They get worried about change, but if you just keep coming with care and compassion and reiterate the purpose and the picture, you keep them from string and getting panicked like, “Something’s going to happen differently.”

If you establish that vision in conjunction with your team, maybe even with some of their input or not, if you lay it out as a purpose-driven mission or something that they can buy into, then as you bring up programs or things that you are changing, you can then reference back to, “Remember we talked about this is where we’re going? This is why this accelerates our path or our progress toward that greater vision?”

Having that very much speaks to the importance of having your values and your purpose clear and explained because then you can reference back to them and say, “This is why we’re doing this. We’re making these changes because what we were doing before didn’t quite align with our values or didn’t seem to, or we’re adding this program because that’s part of our vision. Remember we shared that with you before?” It allows us to come back to the center and remind our team there is a reason behind it. These are our purposes, our ROIs, and this is why we’re moving forward. A lot of times, as you said, people like to change as long as it’s happening around them, but they don’t want to change themselves.

They don’t like change when it’s forced upon them or surprised. That’s why I am sharing it. If you’re going to create a vision and implement it, set up your meeting and share it with your staff. It might not be a bad idea to get your managers on board first so then they become your cheerleaders for the rest of the staff. Share your vision with your leadership team then take it to everybody else.

People don't like change when it's forced upon them.
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I even often recommend that when people are going to share their vision, is have an activity where they can offer suggestions, so they start to feel that piece of it that they are a part of it. Otherwise, they feel like, “Here comes change. What’s going to matter?” People do like change if they have a choice, have some control over it, and have some contribution to it.

If it’s at a rate in which they can manage.

Also, they know where it’s going and the reason why they’re going there.

We’ve all been a part of that, “Let’s do this and this.” I’ve done that. I had to learn that lesson. That’s good stuff, Steve.

I’ve seen also, too, working with clients who work in the corporate world. When change is given to you with no reason, why, and no plan, it is disruptive. As practice owners, I encourage you to keep sharing the purpose and sharing the picture of what it looks like. This is what I need you for. When you’re in meetings, you always touch on, “We’re making progress. We’re at this point when we thought we’d be here. Does anybody see any roadblocks that we can’t see?” Someone else might see a roadblock that we haven’t seen yet.

I’ve been in that situation as you guys. If something changes, you say, “Why? What are we doing this for again?” I don’t find myself being 100% engaged at that point. If you want to engage your team, you need to have that clarity, the conversation, and the why spelled out to them. Maybe even reiterate and remind them so that they stay engaged.

If you’re going to share your vision in a meeting, it might not be a bad idea to take some time and meet with everybody on staff individually because some people won’t bring up suggestions in a group. They’re a little shy. In order to make sure that everybody feels like they’re a part of this, have that connection with the leader or the owner to say, “I want to make sure that you hear everything. Are there any questions?” It will help bring the team together. What a nice step toward being an all-inclusive supportive service leader as you’re engaging them.

I have a question. We’re talking a little bit about meeting with our team, creating alignment, sharing our vision, and all that fun stuff. Especially as a young practice owner, it feels like such a waste of time. It feels like it’s unproductive. It feels like, “Give me some more patience to treat.” Being able to convince practice owners of having a one-hour meeting a week is tough.

The larger your company becomes, the more meetings and the more alignment work that you have, but I don’t ever quite shake the unproductive feeling. Whenever I blocked 4 or 6 hours for a quarterly meeting, and I’ve got all these leaders, I’m like, “$90,000 and $100,000.” It’s about all their salaries. There’s still something inside of me that feels scary. How do you help people get over that? What are your thoughts on that?

The funny thing that I always hear from people is that they always ask like, “Do you feel like your meetings are productive?” 9 times out of 10, it’s a no. “Did you have an intention of what you wanted to get out of that meeting going into it?” Most of the time, it’s like, “Not really. I just want to share.” It’s important for whoever is leading a meeting, to create an intention for themselves, “What is it that I want to get? What do I want everybody to know here?” That will help begin to get you to focus.

It’s also clarifying what type of meeting you’re going to be in. Is this a strategic meeting? Is this an execution meeting? Is this a planning meeting? If it’s a planning meeting, do you need someone who is part of your execution team? Maybe not. Do you have the right people in the room? It’s a matter of getting clear on the meeting, the structure, and the cadence of what you want to get out of it. Otherwise, half the people might be asleep because it doesn’t pertain to them.

Do we even have an outline, or do we have an outline that’s so long that would fill a three-hour meeting when we’re trying to cram it into one? I always tell my clients, too. “Imagine they’re going only to retain 30% of what you say. Think about what you want them to hear, then follow up with something in writing.” If they miss something, if they zoned out, or if you’re having it right after lunch and you know everybody’s going to hit that insulin balance, they’re not going to retain anything you’re saying.

They’re going to sit there and look at you with a blank look on their face. There are a lot of ways to improve meetings. A lot of it is, 1) Less is more. 2) Have a plan and an intention. What outcome do you want again? Like Nathan is saying, “What’s the end in mind? Where do I want to be after this meeting? What do I want people to walk away with?” That’s going to help you focus on what you deliver in that meeting.

We used a number of things from Mastering the Rockefeller Habits by Verne Harnish. He talks specifically about meeting rhythms and how the pace of your meetings can be directly correlated to the progress of your company. He had advocated, especially when you’re a smaller company, to have more frequent meetings. What we found over time was that maybe the pendulum had swung a little too far. We took some time to recognize who is having meetings within the company and how often during the month.

Once we equated that, it turned into 80 hours of meetings every month. Maybe we don’t have to do that. That’s where the tendency goes initially when you think about meetings. How can we cut that back by 50% or 75%, have the same efficacy in our meetings, and get the same progress? That helped. To answer your question, sometimes the answers to that question are quantitative. As we’ve had these meetings, we’ve seen certain productivity metrics increase if you pick the KPI. Maybe because you’ve had those meetings and the particular training related to those meetings, production has increased because you’ve set goals and expectations and trained.

There is a quantitative measure that can come from those meetings as long as, as Steve mentioned, they are specific to something. Also, qualitatively, some of these meetings were simply to improve our culture. There’s not a direct correlation between the amount of lost productivity and the benefits of the meeting because there’s no KPI related to it. Maybe there could be a KPI, whether it’s an NPR score among your employees.

There were some meetings where we had them, like the quarterly town hall. We’d spend a half day. We close down for half a day. A ll the employees came together from four different clinics into a singular clinic. They had a town hall that included training, exercises, and team activities. Part of the benefit of that quarterly town hall was a culture that got established, where people were like, “I know I could make more money elsewhere, but I’m here. I’m going to live and die of this clinic. I love it. There are all the things I learned, all the people that I met, and all the relationships I made.”

You have to recognize what some of the benefits of those meetings are as long as you’re clear that, “Are our meetings effective? Are they getting the results that we wanted?” Also, being clear and intentional about what you’re looking for. That’s what Steve was talking about. Are we clear and intentional about our meetings, the agendas, and what we’re addressing? How do we want people to feel after that? What do we expect after they’re done? What are the big takeaways? Also, laying that out ahead of time so you can have purposeful meetings.

People like to know the agenda, too, ahead of time. This is where you create that space. If you can think ahead and you can have that time to run your practice, send in the agenda ahead of time so they can prepare. They might have questions. It helps make it more efficient and more effective in those meetings.

Thank you so much, Steve, for joining us. We didn’t even ask you from the get-go. Tell us a little bit about you and where people can find you.

I’ve been a PT and a business owner for many years. I sold my practice a few years ago and exited months ago. Now I’m forming my coaching business. It’s called Steve Thompson Coaching, at www.SteveThompsonCoaching.com , and it’s Steve@SteveThompsonCoaching.com if anyone wants to email.

Are you on social media as well?

I’m on LinkedIn , just as my name. I’m not a big social media guy, but I’m keeping it simple. I love to work with people who are navigating the transitions in life because every time you bring a staff person on board, there’s a change in the transition. It’s not like the major life changes, but if someone gets promoted to a new position, there’s a change. As you said, there’s an identity shift.

If an owner steps out of practice and into running the business, there’s an identity shift. If you’re selling your business, there’s an identity shift. All those things need to be managed well. I appreciate you guys for allowing me on here to talk about something that’s so fun and important. Creating a process is so vital to our teams. They need to know where we’re going. They want to know. They want to be part of something, especially this younger generation. They want to be tied to their company. If they don’t, they’re going to be quick to leave.

We’re seeing that more. Thanks for joining us, Steve. I appreciate it.

Thank you, guys. I appreciate you.

It’s been great. Thank you so much.

Steve is certified as a Co-Active Institute Coach, a Designing Your Life Coach, a CBT Coach, and a Working Genius Facilitator to help his clients realize what they truly want in life and then design a life worth living.

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The post The Answer To Feeling “Stuck” Or Lack Of Focus – A PT Owners Club Facebook Live Event With Steve Thompson, Adam Robin, And Nathan Shields appeared first on Physical Therapy Owners Club.